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| Name | Two Methods for Vaginal Vault Suspension at Total Laparoscopic Hysterectomy |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 14-03-2023 19:33:54 |
| Video Discription | This video demonstrates two laparoscopic techniques for suspending the vaginal vault during total laparoscopic hysterectomy (TLH) to prevent post-hysterectomy vault prolapse. The techniques illustrated are the modified McCall’s culdoplasty and the uterosacral ligament suspension, both aimed at securing the vaginal vault to surrounding ligaments to reduce the risk of prolapse following the procedure. Read the full transcript here: https://cansagevideos.com/two-methods-for-vaginal-vault-suspension-at-total-laparoscopic-hysterectomy/ Presented By: Dr. Michael Chaikof Dr. Ari Sanders Dr. May Alarab Dr. Colleen McDermott Dr. Mara Sobel Affiliations: University of Toronto, Mount Sinai Hospital & Women’s College Hospital Timestamps (00:11) Post Hysterectomy Vault Prolapse (PHVP) (0:33) Two Methods for Preventing PHBP at the Time of TLH (0:49) Procedure Video: Technique #1 Modified Mccall's Culdoplasty (03:12) Procedure Video: Single Technique The educational video focuses on addressing the challenge of vault prolapse after a hysterectomy, a common complication that can follow any type of hysterectomy procedure—abdominal, vaginal, or laparoscopic. The video specifically discusses two preventative techniques used during TLH: the laparoscopic modified McCall’s culdoplasty and the laparoscopic uterosacral ligament suspension. Both techniques are intended to secure the vaginal vault at the time of the hysterectomy to prevent future prolapse. The first method, the modified McCall’s culdoplasty, involves using dissolvable monofilament sutures to attach the uterosacral ligaments to the vaginal cuff, thereby suspending it. The procedure ensures careful handling of tissues and precise placement of sutures to avoid damaging adjacent structures like the ureter. The second method, uterosacral ligament suspension, also uses dissolvable sutures but includes additional steps to secure the vaginal cuff to the uterosacral ligaments by incorporating the peritoneum and vaginal mucosa, thereby obliterating the potential space for an enterocele. Both techniques require meticulous surgical skills to ensure that the vaginal cuff is securely suspended and the risk of vault prolapse is minimized. The video details the specific steps involved in each method, emphasizing safety measures like identifying the ureter to avoid injury and using techniques like monopolar electrosurgery for clear demarcation of surgical sites. The final part of the video showcases the outcomes of these methods, demonstrating how the vaginal vault is effectively suspended and supported, potentially enhancing the postoperative recovery and long-term outcomes for patients undergoing TLH. The video concludes by reiterating the importance of these techniques for minimally invasive surgery specialists aiming to prevent post-hysterectomy complications. |
| Category | People & Blogs |
| Tags | vaginal vault suspension | total laparoscopic hysterectomy | vault prolapse | abdominal surgery | vaginal surgery | risk factors | modified McCall's culdoplasty | uterosacral ligament suspension | surgeon's preference | pelvic sidewall | ureter | dissolvable monofilament suture | vaginal cuff angle | peritoneum | contralateral side | intracorporeal technique | tension | monopolar electrosurgery | uterus removal | six sutures | vaginal cuff closure | desiccation | vaginal mucosa | extracorporeal knot |
