, Volume 20, Issue 5, pp 485-486
Date: 20 Mar 2009

Minimally invasive surgery in urogynecology

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Minimally invasive surgery has been a term used to describe laparoscopic surgery and more recently the trocar-guided synthetic mid-urethral slings for stress incontinence and the trocar-guided synthetic mesh kits to treat prolapse. This term implies a lesser operation, more pain free and safer, which in many cases is not true. This description seems more to do with marketing the product and the surgeon than actually describing the benefits and risks of the procedure. When complications occur as they always will, they may be more unexpected by the patient and poorly tolerated. Therefore informed consent, giving the patient a clear understating of the procedure, possible risks and benefits, and likely outcome, is essential.

Synthetic polypropylene slings (SPS) are not new and were used to treat women with stress incontinence by Morgan in Northern America and Moir in the UK in the 1960s. These slings were placed under the bladder neck through open abdominal and vaginal incisions. However,