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Laparoscopic approaches to the retropubic space: three alternatives with anatomical considerations.
- Source :
-
Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy [Minim Invasive Ther Allied Technol] 2021 Jun; Vol. 30 (3), pp. 154-162. Date of Electronic Publication: 2019 Dec 23. - Publication Year :
- 2021
-
Abstract
- Introduction: Many urogynecological and surgical laparoscopic interventions require access to the retropubic space, also known as the space of Retzius. Especially in patients with a history of previous surgery in this area or in general in the lower abdomen, the preparation may be complicated by adhesions and scar tissue. The necessity to combine several laparoscopic procedures in one surgical session may require consideration of the most appropriate way to approach the retropubic space.<br />Material and Methods: We describe and discuss three different options to access the space of Retzius via laparoscopy: the medial transperitoneal, the extraperitoneal and the lateral transperitoneal approach. For all approaches, we used one umbilical trocar and two trocars in the lower abdomen.<br />Results: An algorithm was developed to select the most appropriate access route to the retropubic space, depending on the history of previous surgeries and accompanying interventions.<br />Conclusion: The knowledge of different access routes to the retropubic space offers the possibility of adjusting the surgical procedure to the individual constellation of the patient.
- Subjects :
- Humans
Surgical Instruments
Laparoscopy
Urinary Incontinence, Stress surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2931
- Volume :
- 30
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy
- Publication Type :
- Academic Journal
- Accession number :
- 31868557
- Full Text :
- https://doi.org/10.1080/13645706.2019.1699115