Transvaginal sacrospinous ligament fixation for posthysterectomy vaginal vault prolapse repair
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Introduction and hypothesis
Posthysterectomy vaginal vault prolapse repair is a challenge for urogynecologists. Surgical management can be successful with native tissue by the vaginal approach with sacrospinous ligament fixation. However, severe complications have been described, including nerve injury and life-threatening hemorrhage.
A 68-year-old woman with symptomatic stage III vaginal vault prolapse was admitted for transvaginal sacrospinous ligament fixation according to the described technique.
The surgical procedure was successful without complications. The final examination revealed excellent apical support and preservation of vaginal length. This step-by-step video tutorial may be an important tool for improving surgical knowledge, thus leading to a reduction in the risk of complications. In particular proper suture positioning requires adequate preparation of the pararectal space and exposure of the sacrospinous ligament, as shown in the video.
Transvaginal sacrospinous ligament fixation is a safe and effective technique for apical support without the use of prosthetic materials. Adequate preparation of the pararectal space, direct visualization of the sacrospinous ligament and proper suture positioning are the key points in minimizing the risk of complications.
KeywordsSacrospinous ligament fixation Pelvic organ prolapse Video tutorial Native tissue repair
Compliance with ethical standards
Conflicts of interest
Written informed consent was obtained from the patient for publication of this video article and any accompanying images.
(MP4 92983 kb)
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