Vaginal vault suspension and enterocele repair by Richardson-Saye laparoscopic technique: description of training technique and results.
OBJECTIVE
To describe the Richardson-Saye technique for laparoscopic vaginal vault suspension and enterocele repair (vaginal apex reconstruction) and the appropriate training needed for performance of this technique.


METHODS
Before using this technique, Drs Carter, Winter, and Mendelsohn first received training by observation of skilled surgeons performing the procedure, attending courses, and finally being tutored and proctored by Dr Saye on the appropriate performance of the technique. They then used this technique to surgically treat eight patients, 42 to 85 years of age, mean age 62 years, between March and September of 1999.


RESULTS
We included eight patients in this study who underwent the Saye-Richardson vaginal vault suspension and enterocele repair (apical vaginal vault reconstruction) by the suture technique. In all patients at six-month follow-up, the vaginal apex remains intact and well supported. We describe here the entire vaginal vault suspension and enterocele repair procedure with all its relevant details.


CONCLUSIONS
Laparoscopic reconstruction of the disrupted vaginal apex followed by reattachment to the previously broken uterosacral ligament with the use of permanent suture provides a secure and anatomically correct vault suspension. Before performing this technique, physicians should undergo proper training, including observation, courses, tutoring, and proctorship by a surgeon experienced in performing this technique.
Carter
J E
JE
Women's Health Center of South Orange County Inc, Mission Viego, California 92691, USA. Ultimatev@aol.com
Winter
M
M
Mendehlsohn
S
S
Saye
W
W
Richardson
A C
AC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D005500:Follow-Up Studies; D006176:Gynecology / Q000193:education*; D006547:Hernia / Q000150:complications / Q000175:diagnosis; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000150:complications / Q000175:diagnosis / Q000601:surgery*