DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20151261

A simplified, practical, cost-effective surgical approach to sacrospinous colpopexy

Shalini Mahana Valecha, Divija Dhingra

Abstract


Sacrospinous ligament fixation (SSLF) or colpopexy or colpohysteropexy (when the uterus is conserved) for the treatment of pelvic organ prolapse as a procedure is more than 200 years old. Consequently, umpteen modifications vis-à-vis techniques, instrumentations, lighting options have been described. Most of these make a simple procedure needlessly complex, cumbersome and expensive. We have performed this procedure using a simplified, practical approach with readily available surgical instruments, suture methods and endoscopic lightening apparatus. The main aim of this paper is to highlight the surgical steps of sacrospinous colpopexy performed with simple and easily available routine surgical instruments.


Keywords


Foetal growth restriction, Foetal abdominal circumference, Doppler velocimetry, Screening, Diagnosis, Management

Full Text:

PDF

References


Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501-6.

Berglas B, Rubin IC. Study of the supportive structures of the uterus by levatormyography. Surg Gynecol Obstet. 1953;97(6):677-92.

Marchionni. True incidence of vaginal vault prolapse: thirteen years of experience. J Reprod Med. 1999;44(8):679-84.

Dallenbach P, Kaelin-Gambirasio I, Jacob S. Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunction. 2008;19:1623-29.

Ng CC, Han WH. Comparison of effectiveness of vaginal and abdominal routes in treating severe uterovaginal or vault prolapse. Singapore Med J. 2004;45(10):475-81.

Valecha SM, Dhingra D. Unilateral Sacrospinous Colpohysteropexy Uterus Preserving Surgery for Uterovaginal Prolapse. Medical Science. 2014;5(18):77-80.

Zucchi. Uterus preservation in pelvic organ prolapsed surgery. Nature Reviews Urology. 2010;7(11):626-33.

Maher. Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapses. Int Urogynecol J. 2001;12:381-5.

Valecha SM, Dhingra D. A Systematic Review of A Series of Cases of Vaginal Vault Prolapse Treated With Sacrospinous Ligament Fixation Global Journal For Research Analysis. 2014;3(9).

David-Montefiore E, Barranger E, Dubernard G, Nizard V, Antoine JM, Daraï E. Functional results and quality-of-life after bilateral sacrospinous ligament fixation for genital prolapse. Eur J Obstet Gynecol Reprod Biol. 2007;132(2):209-13.

Cruikshank SH, Muniz M. Outcomes study: a comparison of cure rates in 695 patients undergoing sacrospinous ligament fixation alone and with other site specific procedure a 16-year study. Am J Obstet Gynecol. 2003;188:1509e15.

Hurt WG. Surgical Instruments and Drains. In Gilstrap Lc III, Cunningham FG, Vandorsten JP (eds) Operative Obstetrics. 2nd ed. New York, Mc Graw-Hill. 2002:17.

Valecha SM, Dhingra D. A Prospective Observational Study of Sacrospinous Ligament Fixation. American Journal of Advanced Drug Delivery. 2014;2(4):493-502.

Carey MP, Slack MC. Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse. BJOG: An International Journal of Obstetrics & Gynaecology. 1994:536-40.

Ginsberg DA. Vaginal vault prolapse: evaluation and repair. Current urology reports. 2003:404-8.

Miyazaki FS. Miya hook ligature carrier for sacrospinous ligament suspension. Obstet Gynecol. 1987;70:286-8.

Manning JA, Arnold P. A review of six sacrospinous suture devices. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2014:558-63.

Sharp TR. Sacrospinous suspension made easy. Obstet Gynecol. 1993;82(5):873-5.

Cayrac M, Letouzey V, Ouzaid I, Costa P, Delmas V, de Tayrac R. Anterior sacrospinous ligament fixation associated with paravaginal repair using the Pinnacle™ device: an anatomical study. Int Urogynecol J. 2012;23(3):335-40.

Schlesinger RE. Vaginal sacrospinous ligament fixation with the Autosuture Endostitch device. Am J Obstet Gynecol. 1997;176(6):1358-62.

Given FT, Muhlendorf IK, Browning GM. Vaginal length and sexual function after colpopexy forcomplete uterovaginal eversion. Am J Obstet Gynecol. 1993;169:284-7.