title: Laparoscopy-like operative vaginoscopy: a new approach to manage mesh erosions.
abstract: OBJECTIVE
  Mesh erosion through the vagina is the most common complication of synthetic mesh used for pelvic organ prolapse repair. However, conventional transvaginal mesh excision has many technical limitations. We aimed at creating and describing a new surgical technique for transvaginal removal of exposed mesh that would enable better exposition and access, thus facilitating optimal treatment.
  
  
  METHODS
  A step-by-step video showing the technique.
  
  
  METHODS
  A university tertiary care hospital.
  
  
  METHODS
  Five patients previously submitted to pelvic organ prolapse repair using synthetic mesh, presenting mesh erosion through the vagina.
  
  
  METHODS
  Mesh excision using a laparoscopy-like operative vaginoscopy in which standard laparoscopic instruments are used through a single-incision laparoscopic surgery port device placed in the vagina.
  
  
  RESULTS
  In all cases, a very good exposure of the mesh was achieved, a minimal tissue traction was required, and the procedures were performed in a very ergonomic way. All the patients were discharged on the same day of the surgery and had a painless postoperative course. So far, there have been no cases of relapse.
  
  
  CONCLUSIONS
  This seems to be a simple, cheap, and valuable minimally invasive technique with many advantages in comparison with the conventional approach. More cases and time are necessary to access its long-term efficacy. It may possibly be used for the management of other conditions.
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France.
authors.forename: Valentina
authors.initials: V
authors.lastname: Billone
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France.
authors.forename: Célia
authors.initials: C
authors.lastname: Amorim-Costa
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France.
authors.forename: Sara
authors.initials: S
authors.lastname: Campos
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France.
authors.forename: Benoĭt
authors.initials: B
authors.lastname: Rabischong
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bourdel
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Canis
authors.affiliation: CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France. Electronic address: rbotchorichvili@chu-clermontferrand.fr.
authors.forename: Revaz
authors.initials: R
authors.lastname: Botchorishvili
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D058869:Gynecological Examination / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014621:Vagina / Q000473:pathology / Q000601:surgery
keywords: Laparoscopy; Mesh erosion; Pelvic organ prolapse; Vaginoscopy