title: Laparoendoscopic single-site (LESS) sacrocolpopexy: feasibility and efficacy of knotless procedure performed with conventional instruments.
abstract: The aim of this paper was to report a case of a patient with stage IV vaginal vault prolapse treated by laparoendoscopic single-site (LESS) sacrocolpopexy using an Alexis retractor and a surgical glove attached to three trocars through a 3.5-cm umbilical incision. Only conventional laparoscopic instruments were used for intrabdominal dissection of vagina and peritoneum. The mesh was fixed to the vaginal fornix and to the sacral periosteum from the promontory using running sutures hold in the extremities by polymer clips. The posterior peritoneum was closed over the mesh. LESS sacrocolpopexy performed with conventional instruments is a difficult but feasible and efficient technique to treat vaginal vault prolapse that respects the principles of conventional laparoscopic or open repairs. Alexis retractor associated with knotless sutures are technical options that simplify LESS reconstructive surgical maneuvers.
authors.affiliation: Department of Urology, ABC Medical School, Santo Andre, Brazil. andre.tome@sbu.org.br
authors.forename: Andre Luiz Farinhas
authors.initials: AL
authors.lastname: Tome
authors.forename: Marcos
authors.initials: M
authors.lastname: Tobias-Machado
authors.forename: Walter Fernandes
authors.initials: WF
authors.lastname: Correa
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D013536:Suture Techniques