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Rectal injury during laparoscopic mesh removal after sacrocervicopexy

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Abstract

In this video we present a case of rectal injury, which occurred during laparoscopic mesh removal following sacrocervicopexy. Four years after sub-total hysterectomy with laparoscopic sacrocervicopexy, a 64-year-old patient still suffered from intense proctalgia and pain while sitting. On physical examination, intense pain could be triggered by palpating the left aspect of the levator ani muscle, raising the suspicion of an association with the mesh and leading to the decision for its removal. The left posterior arm of the mesh was removed completely laparoscopically. During this procedure, a rectal lesion was diagnosed and immediately repaired by a double layer of interrupted sutures. There was an immediate and complete resolution of the symptoms after surgery, with no short-term prolapse recurrence or postoperative complications. Laparoscopy appears to be an efficient approach to mesh excision. A high level of alertness to recognize intraoperative injuries is warranted.

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Authors and Affiliations

  1. Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, 9 rue Quatrefages, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, 75005, Paris, France

    Ohad Gluck, Ehud Grinstein & Bruno Deval

  2. Department of Gynecology, University Medical Center, Ljubljana, Slovenia

    Mija Blaganje

  3. Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria

    Nikolaus Veit-Rubin

Authors
  1. Ohad Gluck
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  2. Ehud Grinstein
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  3. Mija Blaganje
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  4. Nikolaus Veit-Rubin
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  5. Bruno Deval
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Correspondence to Bruno Deval.

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Gluck, O., Grinstein, E., Blaganje, M. et al. Rectal injury during laparoscopic mesh removal after sacrocervicopexy. Int Urogynecol J 31, 835–837 (2020). https://doi.org/10.1007/s00192-019-04168-5

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  • DOI: https://doi.org/10.1007/s00192-019-04168-5

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