title: Translevator posterior intravaginal slingplasty: anatomical landmarks and safety margins.
abstract: The posterior intravaginal sling is a new tension-free needle suspension technique. It is used for the treatment of middle compartment (vaginal vault or uterine) prolapse. The Prolene sling suspends the vagina at the upper border of level II support as described by DeLancey (Am J Obstet Gynecol 166:1717, 1992). Human cadaveric dissections were undertaken to explore the pertinent anatomy that is involved when using this blind needle technique. Pre-dissected cadaveric material was used to obtain didactic illustrations of the anatomy of the procedure. Description of the surgical technique using anatomical landmarks and relative distances of the needle to these landmarks will improve the surgeon's visual understanding of the procedure. The measurements obtained demonstrate that the needle stays at a minimal distance of 4 cm away from the major (pudendal) vessels that could potentially cause life-threatening haemorrhage.
authors.affiliation: Department of Obstetrics and Gynaecology, Clinique Sainte Anne-Saint Rémi, Bd. Graindor 66, 1070, Brussels, Belgium. dr_smajda@hotmail.com
authors.forename: Stefan
authors.initials: S
authors.lastname: Smajda
authors.forename: Linda
authors.initials: L
authors.lastname: Vanormelingen
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vandewalle
authors.forename: Willem
authors.initials: W
authors.lastname: Ombelet
authors.forename: Eric
authors.initials: E
authors.lastname: de Jonge
authors.forename: Piet
authors.initials: P
authors.lastname: Hinoul
mesh_terms: D002102:Cadaver; D005260:Female; D006801:Humans; D010388:Pelvis / Q000033:anatomy & histology*; D019919:Prosthesis Implantation / Q000295:instrumentation*; D013526:Surgical Mesh; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*