Hellow guys, Welcome to my website, and you are watching Robotic Assisted Laparoscopic Apical Suspension. 4 points technique (RALAS-4): first case reported. and this vIdeo is uploaded by Hugo H Davila at 2017-09-12T06:19:39-07:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | Robotic Assisted Laparoscopic Apical Suspension. 4 points technique (RALAS-4): first case reported |
| Video Uploader | Video From Hugo H Davila |
| Upload Date | This Video Uploaded At 12-09-2017 13:19:39 |
| Video Discription | Paper Publication: http://www.scirp.org/Journal/PaperInformation.aspx?PaperID=79012 The uterosacral ligaments (UTSL), together with the cardinal ligament (CL), hold the upper vagina and cervix over the levator plate. These 2 ligaments provided 4 points support at the apex. Here we describe our surgical technique of robotic assisted laparoscopic apical suspension (RALAS) using non-absorbable sutures and describe a new 4 points technique (RALAS-4). For RALAS-4, we used V-Loc 3-0, CV-23(Covidien) sutures (absorbable) on the right and left uterosacral ligaments (2 points) and theses were reinforced with Gore-Tex 2-0, CV-2 (non-absorbable, Gore Medical). On the right/left anterior apical support we used Gore-Tex 2-0 and these provided the 2 point suspension (UTLS=2 and anterior vagina=2). The 2 anterior apical support sutures are taken from the vagina to the transversalis fascia and the obliterated umbilical artery on the anterior abdominal wall. The tension of these anterior sutures was maintained with Hem-o-lock (TeleFlex) and LAPRA-TY (Ethicon). In our opinion RALAS-4 may represents an alternative to robotic or laparoscopic sacrocolpopexy. This new approach simulate the natural 4 points support given by uterosacral ligaments and cardinal ligament, with the additional benefit of no mesh and no dissection on the sacrum promontory. With this technique we are chasing the Trifecta: no mesh, no complications and good anatomic support. |
| Category | Education |
| Tags | Apical prolapse | vaginal prolapse | pelvic anatomy | robotic surgery | uterosacral ligament | cardinal ligament. | pelvic organ prolapse | repair of prolapses |
