title: Sacrospinous ligament fixation by palpation: variation of the Richter procedure.
abstract: OBJECTIVE
  To present our method of sacro-spinous ligament fixation by palpation and compare it to the classical approach described by Richter.
  
  
  METHODS
  In addition to the standard instruments needed for vaginal surgery, we use a Rasemond dissector, a small O'Shaugnessy dissector with smooth branches. We also use a Bengolea forceps and a monothread-nylon (Ethilon), decimal 4 suture loaded on a needle with a 30-mm curve.
  
  
  METHODS
  Twenty patients underwent this procedure from 03/15/1978 to 05/19/1995. Their ages ranged from 46 to 86 years with a mean age of 64.7 years.
  
  
  METHODS
  This was a retrospective study of the indications, results and complications associated with this technique.
  
  
  RESULTS
  With an average follow-up of 7 years, we observed 90% success, 10% recurrences, and no complication directly attributable to this technique. This technique is valuable because of its effectiveness and simplicity.
  
  
  CONCLUSIONS
  Sacrospinous fixation by palpation is more simple and provides the same results as the classic exposure technique. We describe the technique in this text. The efficacy of sacro-spinous ligament fixation by palpation would be improved by its systematic and bilateral use. Its value must be confirmed by a controlled prospective study to confirm our impression that our technique carries fewer risks.
authors.affiliation: Centre Hospitalier de Thonon les Bains, France.
authors.forename: J
authors.initials: J
authors.lastname: Salvat
authors.forename: L
authors.initials: L
authors.lastname: Slamani
authors.forename: A
authors.initials: A
authors.lastname: Vincent-Genod
authors.forename: D
authors.initials: D
authors.lastname: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008022:Ligaments; D008875:Middle Aged; D010173:Palpation; D011183:Postoperative Complications; D012189:Retrospective Studies; D012447:Sacrum; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000209:etiology / Q000601:surgery*