title: Laparoscopic-assisted Retropubic Midurethral Sling Placement: A Technique to Avoid Major Complications.
abstract: To describe a technique for the safe placement of retropubic midurethral slings in patients undergoing concomitant laparoscopic surgery in order to avoid major complications associated with this procedure such as bladder perforation and retropubic hematomas.
  
  
  
  Step-by-step video demonstration of the technique.
  
  
  
  A university tertiary care hospital.
  
  
  
  Patients with an indication for retropubic midurethral sling placement because of recurrent stress urinary incontinence, intrinsic sphincter deficiency, or severe pelvic organ prolapse in whom a concomitant laparoscopic surgery has to be performed for other medical conditions.
  
  
  
  Laparoscopic opening and dissection of the Retzius space and insertion of the sling under a laparoscopic view of this space.
  
  
  
  This technique has been mainly used in patients undergoing laparoscopic pelvic organ prolapse repair. No complications have been identified so far, even in high-risk patients such as those with previous Burch colposuspension.
  
  
  
  This is a simple and reproducible technique for preventing major complications associated with retropubic sling placement in patients undergoing laparoscopic surgery for other reasons. It also permits the immediate detection and even resolution of complications in case any arise. Even high-risk patients may be safely approached.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France; Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Célia
authors.initials: C
authors.lastname: Amorim-Costa
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France; Department of Mother and Child, University Hospital P. Giaccone, Palermo, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Billone
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Rabischong
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bourdel
authors.affiliation: Department of Mother and Child, University Hospital P. Giaccone, Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Cucinella
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Canis
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France. Electronic address: rbotchorichvili@chu-clermontferrand.fr.
authors.forename: Revaz
authors.initials: R
authors.lastname: Botchorishvili
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D053825:Suburethral Slings / Q000009:adverse effects; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods
keywords: Complications; Laparoscopy; Retropubic sling; Retzius; Tension free Vaginal Tape