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International Urogynecology Journal
Published in: International Urogynecology Journal 12/2017

01-12-2017 | IUJ Video

Demonstration of a box-stitch technique for laparoscopic uterosacral ligament suspension

Authors: Allison M. Wyman, Lindsey Hahn, Emad Mikhail, Stuart Hart

Published in: International Urogynecology Journal | Issue 12/2017

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Abstract

Aim

We demonstrate a novel box stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension for apical prolapse in restorative pelvic reconstructive surgery.

Material and methods

We present a case of a 58yo female with symptomatic stage III pelvic organ prolapse with a history of a total abdominal hysterectomy 30 years prior. She strongly desired the usage of no synthetic or biologic mesh for her restorative surgical repair. This video provides a step-by-step guide on how to perform a laparoscopic box stitch as a technique for uterosacral ligament suspension as an apical native tissue option for patients with the need for post hysterectomy apical prolapse.

Conclusion

This video demonstrates a novel box-stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension as a native tissue option for minimally invasive reconstructive surgery. The procedure is a reasonable option to address apical prolapse in patients who do not desire or who are unable to have synthetic or biologic mesh placed for restorative reconstructive prolapse surgery.
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Literature
1.
Filmar, G.A., et al., Laparoscopic uterosacral ligament suspension and sacral colpopexy: results and complications. Int Urogynecol J, 2014.
2.
Rardin CR, et al. Uterosacral colpopexy at the time of vaginal hysterectomy: comparison of laparoscopic and vaginal approaches. J Reprod Med. 2009;54(5):273–80.PubMedPubMedCentral
3.
Turner LC, Lavelle ES, Shepherd JP. Comparison of complications and prolapse recurrence between laparoscopic and vaginal uterosacral ligament suspension for the treatment of vaginal prolapse. Int Urogynecol J. 2016 May;27(5):797–803.CrossRefPubMed
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Vallabh-Patel V, Saiz C, Salamon C. Subjective and objective outcomes of robotic and vaginal high uterosacral ligament suspension. Female Pelvic Med Reconstr Surg. 2016;22(6):420–4.CrossRefPubMed
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Lin LL, Phelps JY, Liu CY. Laparoscopic vaginal vault suspension using uterosacral ligaments: a review of 133 cases. J Minim Invasive Gynecol. 2005;12(3):216–20.CrossRefPubMed
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Wyman AM, Rodrigues Jr AA, Hahn L, Greene KA, Bassaly R, Hart S, Miladinovic B, Hoyte L. Estimated levator ani subtended volume: a novel assay for predicting surgical failure after uterosacral ligament suspension. Am J Obstet Gynecol. 2016;214(5):611.e1–6.CrossRef
Metadata
Title
Demonstration of a box-stitch technique for laparoscopic uterosacral ligament suspension
Authors
Allison M. Wyman
Lindsey Hahn
Emad Mikhail
Stuart Hart
Publication date
01-12-2017
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 12/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3335-2

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