PFD Week 2016-Laparoscopic Mesh Sacrohysteropexy With Concurrent Laparoscopic Myomectomy for Multiple Fibroids

Laparoscopic Mesh Sacrohysteropexy With Concurrent Laparoscopic Myomectomy for Multiple Fibroids

Video Transcription

Video Summary

This video demonstrates a laparoscopic mesh sacrohysterepexy procedure performed in a patient who wanted to preserve her uterus. The surgery involves placing a mesh to support the uterus and treating any fibroids. Pedunculated fibroids are removed first, followed by intramural fibroids which are treated with a pertussin solution to minimize bleeding. The fibroids are then removed using electrical and ultrasonic energy, and the uterus is debulked to a suitable size. The defects from the myomectomies are closed using barbed and laparoscopic sutures. A piece of mesh is then attached to the body of the uterus, and if needed, extended to the posterior vaginal wall. The mesh is attached to the presacral ligament, and excess suture and mesh are removed. The mesh is retroperitonealized to minimize complications. The final position of the uterus is checked, and any removed fibroids are extracted. The patient had successful results with no complications. This technique, performed by experienced surgeons, can be done alongside laparoscopic myomectomy in select patients. Patients should be informed of the risks associated with mesh-related complications.

Asset Subtitle

John Miklos, MD

Keywords

laparoscopic mesh sacrohysterepexy procedure

uterus preservation

fibroid removal

mesh support

laparoscopic myomectomy