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Laparoscopic lateral suspension for pelvic organ prolapse in a case with difficulty in performing laparoscopic sacrocolpopexy

Authors :
Sheryl Ghia Gonocruz
Tokumasa Hayashi
Shino Tokiwa
Yuko Yoshio
Yoshiyuki Okada
Jimmy Nomura
Yasuhide Kitagawa
Yugo Sawada
Source :
IJU Case Reports
Publication Year :
2019
Publisher :
John Wiley and Sons Inc., 2019.

Abstract

Introduction Mesh fixation at the promontory is the most important procedure in laparoscopic sacrocolpopexy. We present a case of pelvic organ prolapse wherein sacrocolpopexy was converted to lateral suspension intraoperatively due to tissue weakness of the promontory. Case presentation A 66-year-old woman with a sensation of bulge in the vagina presented to our clinic. She was diagnosed with uterine prolapse (grade III). Laparoscopic sacrocolpopexy was planned; exposure of the promontory and mesh fixation at the vesicovaginal and rectovaginal space could be smoothly performed. However, handling the needle at the promontory was impossible due to tissue weakness of the anterior longitudinal ligament of the sacrum. Consequently, mesh fixation was converted to lateral suspension. Conclusion Difficult mesh fixation at the promontory is not rare in laparoscopic sacrocolpopexy. Lateral suspension may be useful as a trouble-shooting procedure for laparoscopic sacrocolpopexy, and surgeons performing laparoscopic sacrocolpopexy should know this procedure.

Details

Language :
English
ISSN :
2577171X
Volume :
2
Issue :
3
Database :
OpenAIRE
Journal :
IJU Case Reports
Accession number :
edsair.doi.dedup.....067b1856d578303b26d6cbb9e0090a7d