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International Urogynecology Journal

, Volume 26, Issue 10, pp 1541–1543 | Cite as

Use of a vessel loop to ensure tunnel patency during LeFort colpocleisis

  • Sybil G. DessieEmail author
  • Peter L. Rosenblatt
IUJ Video
  • 218 Downloads

Abstract

Introduction

The objective was to describe a novel method for maintaining bilateral channel patency for potential uterine drainage during LeFort colpocleisis.

Methods

This video presents a novel approach for ensuring bilateral channel patency during colpocleisis. An 88-year-old gravida 2 para 2 with stage 4 uterovaginal prolapse presented for definitive surgical management. She was no longer sexually active. After counseling on various treatment options, she elected to proceed with a LeFort colpocleisis.

During the procedure, the vaginal epithelium is dissected off the underlying tissue with sharp dissection after infiltration with local anesthetic. After the epithelium is removed anteriorly and posteriorly, a blue vessel loop is placed across the cervix and within the lateral channels as they are created with a series of figure of eight stitches. Care is taken to suture around and not through the vessel loop. This is done on both sides. The anterior and posterior dissected surfaces of the vagina are then reapproximated to involute the vagina until the distal epithelial edges can be brought together. Once the vaginal epithelial edges are sewn, the vessel loop is easily pulled through, ensuring channel patency.

Conclusions

The vessel loop technique demonstrated in this video allows the surgeon to ensure that the bilateral channels remain patent throughout the procedure.

Keywords

Colpocleisis Pelvic organ prolapse Surgery 

Notes

Consent

Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Conflicts of interest

None.

Supplementary material

ESM 1

(MP4 96576 kb)

References

  1. 1.
    Smith FJ, Holman CD, Moorin RE, Tsokos N (2010) Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol 116(5):1096–1100CrossRefPubMedGoogle Scholar
  2. 2.
    Fitzgerald MP, Richter HE, Bradley CS, Ye W et al (2008) Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis. Int Urogynecol J Pelvic Floor Dysfunct 19(12):1603–1609PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Department of Obstetrics, Gynecology and Reproductive BiologyHarvard Medical SchoolBostonUSA
  3. 3.Department of Obstetrics and GynecologyMount Auburn HospitalCambridgeUSA

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