Skip to main content
Top
Published in: International Urogynecology Journal 2/2011

01-02-2011 | Original Article

A new laparoscopic technique for uterine prolapse: one-sided uterine fixation through the round ligament

Author: Ching-Hung Hsieh

Published in: International Urogynecology Journal | Issue 2/2011

Login to get access

Abstract

Introduction and hypothesis

In this study, we provide a description of laparoscopic uterine suspension technique through round ligament.

Methods

From 1997 to 2010, 55 patients with uterine prolapse were treated by laparoscopic uterine suspension. It is performed by suturing and tying a 1-0 Ethibond on the left round ligament at its insertion into the uterus. Then curved forceps pass the lateral puncture wound into the extraperitoneal space along the round ligament and penetrates the anterior leaf of the broad ligament into the peritoneal cavity and grasps the free ends of the Ethibond. They are withdrawn extraperitoneally along the round ligament then tightly tied at the fasciae on either side of the lateral puncture wound.

Results

Forty-two out of 55 patients (76.4%) experienced a reduction of prolapse to stage 0, regardless of what stage they started from. Twelve out of 55 (21.8%) experienced a reduction of prolapse varying from one to two stages. One out of 55 (1.8%) experienced no reduction in prolapse.

Conclusions

This technique reconstructs a new, inelastic round ligament.
Literature
1.
go back to reference Olsen AL, Smith VJ, Bergstorm JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed Olsen AL, Smith VJ, Bergstorm JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed
2.
go back to reference Diwan A, Rardin CR, Kohli N (2004) Uterine preservation during surgery for uterovaginal prolapse: a review. Int Urogynecol J 15:286–292 Diwan A, Rardin CR, Kohli N (2004) Uterine preservation during surgery for uterovaginal prolapse: a review. Int Urogynecol J 15:286–292
3.
go back to reference Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM (2010) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 4:CD004014PubMed Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM (2010) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 4:CD004014PubMed
4.
go back to reference Lin LL, Ho MH, Haessler AL, Betson LH, Alinsod RM, Liu CY, Bhatia NN (2005) A review of laparoscopic uterine suspension procedures for uterine preservation. Curr Opin Obstet Gynecol 17:541–546CrossRefPubMed Lin LL, Ho MH, Haessler AL, Betson LH, Alinsod RM, Liu CY, Bhatia NN (2005) A review of laparoscopic uterine suspension procedures for uterine preservation. Curr Opin Obstet Gynecol 17:541–546CrossRefPubMed
5.
go back to reference O’Brien PM, Ibralim J (1994) Failure of laparoscopic uterine suspension to provide a lasting cure for uterovaginal prolapse. Br J Obstet Gynaecol 101:707–708CrossRefPubMed O’Brien PM, Ibralim J (1994) Failure of laparoscopic uterine suspension to provide a lasting cure for uterovaginal prolapse. Br J Obstet Gynaecol 101:707–708CrossRefPubMed
6.
go back to reference Candy JW (1976) Modified Gilliam uterine suspension using laparoscopic visualization. Obstet Gynecol 47:242–243PubMed Candy JW (1976) Modified Gilliam uterine suspension using laparoscopic visualization. Obstet Gynecol 47:242–243PubMed
7.
8.
go back to reference Massouda D, Ling FW, Muram D et al (1987) Laparoscopic uterine suspension with Falope rings. J Reprod Med 32:859–861PubMed Massouda D, Ling FW, Muram D et al (1987) Laparoscopic uterine suspension with Falope rings. J Reprod Med 32:859–861PubMed
9.
go back to reference Gordon SF (1992) Laparoscopic uterine suspension. J Reprod Med 37:615–616PubMed Gordon SF (1992) Laparoscopic uterine suspension. J Reprod Med 37:615–616PubMed
10.
go back to reference Bump RC, Mittiasson A, Bo K, Brubaker LP et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed Bump RC, Mittiasson A, Bo K, Brubaker LP et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed
11.
go back to reference Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178CrossRefPubMed Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178CrossRefPubMed
12.
go back to reference Ostrzenski A (1998) Laparoscopic retroperitoneal hysteropexy. A randomized trial. J Reprod Med 43:361–366PubMed Ostrzenski A (1998) Laparoscopic retroperitoneal hysteropexy. A randomized trial. J Reprod Med 43:361–366PubMed
13.
go back to reference Carter JE (1999) Carter-Thomason uterine suspension and positioning by ligament investment, fixation and truncation. J Reprod Med 44:417–422PubMed Carter JE (1999) Carter-Thomason uterine suspension and positioning by ligament investment, fixation and truncation. J Reprod Med 44:417–422PubMed
14.
go back to reference Gargiulo T, Leo L, Gomel V (2000) Laparoscopic uterine suspension using three-stitch technique. J Am Assoc Gynecol Laparosc 7:233–235CrossRefPubMed Gargiulo T, Leo L, Gomel V (2000) Laparoscopic uterine suspension using three-stitch technique. J Am Assoc Gynecol Laparosc 7:233–235CrossRefPubMed
15.
go back to reference Batioglu S, Zeyneloglu HB (2000) Laparoscopic plication and suspension of the round ligament for chronic pelvic pain and dyspareunia. J Am Gynecol Laparosc 7:547–551CrossRef Batioglu S, Zeyneloglu HB (2000) Laparoscopic plication and suspension of the round ligament for chronic pelvic pain and dyspareunia. J Am Gynecol Laparosc 7:547–551CrossRef
16.
go back to reference Ou CS, Liu YH, Joki JA, Rowbotham R (2002) Laparoscopic uterine suspension by round ligament plicaiton. J Reprod Med 47:211–216PubMed Ou CS, Liu YH, Joki JA, Rowbotham R (2002) Laparoscopic uterine suspension by round ligament plicaiton. J Reprod Med 47:211–216PubMed
17.
go back to reference Perry CP, Presthus J, Nieves A (2005) Laparoscopic uterine suspension for pain relief: a multicenter study. J Reprod Med 50:567–570PubMed Perry CP, Presthus J, Nieves A (2005) Laparoscopic uterine suspension for pain relief: a multicenter study. J Reprod Med 50:567–570PubMed
18.
go back to reference Whiteside JL, Barber MD, Walters MD, Falcone T (2003) Anatomy of ilioinguinal and iliohypogastric nerves in relation to trocar placement and low transverse incisions. Am J Obstet Gynecol 189:1574–1578CrossRefPubMed Whiteside JL, Barber MD, Walters MD, Falcone T (2003) Anatomy of ilioinguinal and iliohypogastric nerves in relation to trocar placement and low transverse incisions. Am J Obstet Gynecol 189:1574–1578CrossRefPubMed
Metadata
Title
A new laparoscopic technique for uterine prolapse: one-sided uterine fixation through the round ligament
Author
Ching-Hung Hsieh
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 2/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1269-z

Other articles of this Issue 2/2011

International Urogynecology Journal 2/2011 Go to the issue