title: Natural orifice vaginal sacrocolpopexy (NOVaS): a cadaver feasibility study.
abstract: OBJECTIVE
  The primary objective was to determine the feasibility of a vaginal approach to sacrocolpopexy using a cadaver model. Secondary objectives were to measure the distance from the vaginal introitus to the sacrum and distances of the sacral fixation elements to other vital structures.
  
  
  METHODS
  Fourteen fresh-frozen cadavers were used. Specialized instruments were developed to optimize visualization and facilitate performance of the procedure.
  
  
  RESULTS
  Five cadavers had a transperineal approach (an approach found unfeasible), and eight of the remaining nine had complete or partial completion of the transvaginal approach. The mean distance from the introitus to the promontory was 14.6 cm (12-16.5 cm). The mean distance from the sacral fixation elements to the aorta was 5.2 cm; common iliac artery, 3.5 cm; internal iliac artery, 3.25 cm; middle sacral artery, 1.75 cm, and ureters, 3.5 cm. The position of the sacral fixation elements was consistently at the level of S1-2.
  
  
  CONCLUSIONS
  Vaginal sacrocolpopexy is feasible in a cadaver model.
authors.affiliation: Department of Obstetrics and Gynecology, Female Pelvic Medicine and Reconstructive Surgery, University of California, Irvine, Orange, CA 92868, USA. knoblett@uci.edu
authors.forename: Karen L
authors.initials: KL
authors.lastname: Noblett
authors.forename: Miles
authors.initials: M
authors.lastname: Murphy
authors.forename: Nathan
authors.initials: N
authors.lastname: Guerette
mesh_terms: D002102:Cadaver; D003127:Colposcopy / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods*; D012447:Sacrum / Q000601:surgery; D013526:Surgical Mesh; D013537:Sutures; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery
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