Endoscopic lateral fixation using a T-shaped mesh implant is an effective way of correcting apical genital prolapse
Objective. To determine the effectiveness of endoscopic lateral fixation using a mesh implant as an alternative method for correcting apical prolapse.Aryutin D.G., Vaganov E.F., Belousova A.A., Toktar L.R., Toniyan K.A., Orazov M.R., Dukhin A.O.
Subjects and methods. During the prospective study, the results of treatment were analyzed in 25 patients with apical prolapse, who underwent laparoscopic fixation of the cervix uteri, its stump or vaginal vault, by using a T-shaped polypropylene implant (Prof. J.B. Dubuisson).
Results. The duration of surgery averaged 85 minutes. Intraoperative blood loss averaged 100 ml. There was a significant postoperative improvement in 20 of the 25 patients.
Conclusion. Laparoscopic lateral fixation using a T-shaped mesh implant to correct apical genital prolapse is an effective, technically feasible, and safe alternative to sacropexy and its performance requires no expert proficiency level in endoscopic surgery.
Keywords
pelvic organ prolapse
apical prolapse
sacropexy
prolene implants
lateral fixation
Supplementary Materials
- Table. Characteristics of used reticular implants
- Fig. 1. A mesh implant for fixing the stump of the cervix (1) and the dome of the vagina (2). a - sleeve implant, b - central flap
- Fig. 2. Features of fixing the reticular implant (Prof. JB Dubuisson)
- Fig. 3. Fixation of the reticular implant, formed tunnels under the parietal peritoneum for carrying out the arms of the reticular implant
- Fig. 4. Results of surgical treatment and prolapse according to the questionnaires
References
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Received 14.04.2017
Accepted 28.04.2017
About the Authors
Aryutin Dmitry Gennadievich., Candidate of Medicine, Assistant of the Department of obstetrics and gynecology with course Perinatology Peoples’ Friendship Universityof Russia, head of the gynecological department, N.E. Bauman City Clinical Hospital Twenty-Nine, Moscow Healthcare Department.
111020, Russia, Moscow, Gospitalnaya pl. 2. Tel.: +79037729538. E-mail: aryutin@mail.ru.
Vaganov Evgeny Fedorovich, Candidate of Medicine, obstetrician-gynecologist, N.E. Bauman City Clinical Hospital Twenty-Nine, Moscow Healthcare Department.
111020, Russia, Moscow, Gospitalnaya pl. 2. Tel.: +79099299009. E-mail: vaganov83@mail.ru
Belousova, Alexandra Andreevna, obstetrician-gynecologist, N.E. Bauman City Clinical Hospital Twenty-Nine, Moscow Healthcare Department.
111020, Russia, Moscow, Gospitalnaya pl. 2. Tel.: +79262468576. E-mail: firemouse@mail.ru
Toktar Lily Railevna, Assistant Professor of obstetrics and gynecology with course of Perinatology, Peoples’ Friendship University of Russia.
117198, Russia, Moscow, Miklukho-Maklaya str. 21- 3. Tel.: +79031413907
Toniyan Konstantin Alexandrovich, head of the gynecological Department of Clinical hospital № 1, Administrative Department of the President of the Russian Federation. 121352, Russia, Moscow, Starovolinskaya str. 10. Tel.: +79164664661. E-mail: ktoniyan@mail.ru
Dukhin Armen Olegovich., Doctor of Medicine, Professor, Department of obstetrics and gynecology with course of Perinatology, Peoples’ Friendship University of Russia,
head of the gynecological Department of the Central clinical hospital № 6 “RZD”.
109388, Russia, Moscow, Shosseinaya str. 43. Tel.: +79161782556. E-mail: aodukhin@maill.ru
Orazov Mekan Rahimberdievich, Doctor of Medicine, Assistant Professor of obstetrics and gynecology with course of Perinatology, Peoples’ Friendship University of Russia, obstetrician-gynecologist. 117198, Russia, Moscow, Miklukho-Maklaya str. 21-3. Tel.: +79152375292. E-mail: omekan@mail.ru
For citations: Aryutin D.G., Vaganov E.F., Belousova A.A., Toktar L.R., Toniyan K.A., Orazov M.R., Dukhin A.O. Endoscopic lateral fixation using a T-shaped mesh implant is an effective way of correcting apical genital prolapse. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 120-5. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.120-125
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