title: Laparoscopic excision of sacrocolpopexy mesh.
abstract: OBJECTIVE
  To demonstrate surgical maneuvers to facilitate laparoscopic excision of sacrocolpopexy mesh and prevent potential complications.
  
  
  METHODS
  Step-by-step illustration of various surgical techniques using a video compiled from 3 laparoscopic sacrocolpopexy mesh excision procedures performed at Magee-Womens Hospital for various indications (Canadian Task Force classification xx-xx).
  
  
  METHODS
  Mesh complications such as infection and erosion are frequently managed conservatively but often necessitate mesh excision for symptom relief. Laparoscopic excision of sacrocolpopexy mesh procedures is typically challenging, even in the hands of experienced surgeons. Synthetic mesh, being a foreign body, activates an inflammatory process that leads to surrounding tissue fibrosis and scar tissue formation that can distort the pelvic anatomy, thereby putting vital organs at risk of injury. Such organs include the bladder, rectum, and vagina caudally; the left common iliac vein and middle sacral vessels cephalad; and the ureters at the level of the vaginal cuff angles.
  
  
  METHODS
  Laparoscopic excision of sacrocolpopexy mesh.
  
  
  CONCLUSIONS
  When planning laparoscopic sacrocolpopexy mesh excision, complications can be prevented with use of proper surgical technique. It is important to identify vital structures because they may be displaced due to tissue fibrosis. When developing various surgical planes, surgeons should first operate in areas that are free of adhesions. This will enhance exposure when dissecting the mesh in proximity of scarred tissue and vital organs. Use of vaginal and rectal probes helps to delineate the vesicovaginal and rectovaginal spaces to prevent bladder and bowel injury.
authors: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: dinachamsy@hotmail.com.
authors: Dina
authors: D
authors: Chamsy
authors: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors: Ted
authors: T
authors: Lee
mesh_terms: D002170:Canada; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013526:Surgical Mesh / Q000009:adverse effects*; D001743:Urinary Bladder / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
keywords: Laparoscopy; Mesh complications; Sacrocolpopexy mesh excision