AUGS/IUGA Scientific Meeting 2019-Novel Surgical Approach Incorporating a Dermal Allograft with the Sacropinous and Uterosacral Ligaments to address Apical Prolapse

Novel Surgical Approach Incorporating a Dermal Allograft with the Sacropinous and Uterosacral Ligaments to address Apical Prolapse

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Video Transcription

Video Summary

In this video, a 64-year-old female with post-hysterectomy vaginal vault prolapse undergoes a surgical procedure to improve apical support in both the anterior and posterior vaginal apex. The surgeon begins by evaluating the prolapse and marking the desired location of the apex. Hydrodissection is used to dissect the anterior and posterior walls, followed by repair of the endopelvic fascia using sutures. The sacrospinous ligament is also addressed for support. A single incision sling is placed for urethral support. The posterior endopelvic fascia and uterus sacral ligaments are repaired, and an allograft is utilized to reinforce the apex. Posterior and anterior vaginal mucosa are removed and closed, and the procedure is completed with perineurophy and cystoscopy to ensure ureteral patency.

Asset Caption

Barry K Jarnagin, MD

Keywords

post-hysterectomy vaginal vault prolapse

surgical procedure

apical support

endopelvic fascia repair

sacrospinous ligament support