Laparoscopic repair of enterocele.
The repair of an enterocele has classically been via a transvaginal or open abdominal route. With the availability of minimally invasive procedures, we applied established laparoscopic techniques to enterocele repair. Three women with a history of hysterectomy had a symptomatic enterocele as well as a cystocele or rectocele. Each underwent a transperitoneal laparoscopic enterocele repair prior to a transvaginal rectocele or cystocele repair or laparoscopic colposuspension. Using three trocars and transvaginal digital manipulation, the enterocele was reduced and repaired utilizing a modified Moschocowitz technique. The cul-de-sac was obliterated by approximating the posterior vaginal fascia to the anterior wall of the rectum with a running suture. There was no operative morbidity. The average length of stay was 3.3 days. All patients were asymptomatic with no enterocele recurrence identified during a mean follow-up of 10.5 (range 7-15) months. Laparoscopic enterocele repair is a feasible surgical procedure with minimal morbidity. A larger series with longer follow-up is necessary before the efficacy and proper indications for this minimally invasive procedure are determined.
Cadeddu
J A
JA
James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Micali
S
S
Moore
R G
RG
Kavoussi
L R
LR
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures