Laparoscopic trans teres vault suspension, a new laparoscopic method of treatment of female genital prolapse - a preliminary report.
BACKGROUND
Pelvic organ prolapse (POP) is treated with a great variety of procedures and none is fully satisfactory. The aim of the study was to introduce and evaluate the effectives of laparoscopic trans teres vault suspension (LTTVS) technique as a new method for POP treatment.


METHODS
In the years 2013-2014, eight symptomatic women with grades II-IV POP underwent LTTVS procedure. The mean age of patients was 65.25 years (range from 52 to 76 years). The surgery encompassed total hysterectomy, suturing the vagina and fixation of uterosacral ligaments to the vaginal stump, fixation of stumps of round ligaments to the vaginal stump, and fixation of the vaginal stump to the anterior rectus fascia. Mean follow-up was 17.75 months (range from 6 to 27 months).


RESULTS
Eight patients were successfully operated. The symptoms of POP resolved after surgery and subjective quality of life increased. In one case a complication such as common fibular nerve injury appeared; however, it resolved after one month of physiotherapy. The other patient reported radiating pain down the leg after three months. No recurrence of vaginal stump prolapse was observed during the follow-up.


CONCLUSIONS
LTTVS is a promising method for POP treatment. Due to repair with the use of native tissues, physiological placement of vaginal stump, and high efficacy it can be considered as an alternative to other POP surgeries. The method requires additional research on larger groups of patients.
2 Department and Clinic of Obstetrics and Gynaecology, Wroclaw Medical University, Wroclaw, Poland.
Ewa
E
Milnerowicz-Nabzdyk
2 Department and Clinic of Obstetrics and Gynaecology, Wroclaw Medical University, Wroclaw, Poland.
Mariusz
M
Zimmer
hysterectomy; laparoscopic; minimally invasive surgery; pelvic organ prolapse; uterine prolapse; vaginal stump suspension