scholarly journals Transvaginalna sakrospinalna kolpopeksija u resavanju uterovaginalnog prolapsa i prolapsa vaginalnih zidova

2004 ◽  
Vol 51 (3) ◽  
pp. 79-83
Author(s):  
R. Argirovic ◽  
I. Likic-Ladjevic ◽  
S. Pantovic
Keyword(s):  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Vaginal Wall ◽  
High Ligation ◽  
Uterovaginal Prolapse ◽  
Complication Rates ◽  
Vault Prolapse ◽  
Time Duration ◽  
Vaginal Repair ◽  
Sacrospinous Colpopexy

Investigation has been performed upon 29 patients of average age of 62,7 years who have undergone sacrospinous colpopexy because of different degree of uterovaginal prolapse (26 patients) and vaginal vault prolapse (3 patients) after having abdominal or vaginal hysterectomy. In patients with uterovaginal prolapse, 23 of them have vaginal hysterectomy with high ligation of the enterocele sac, anterior et posterior vaginal repair and sacrospinous colpopexy, while 3 patients had conservation of uterus following previous reparation of vaginal walls and cervi- cosacrocolpopexy. Only in one patient we had intraoperative lession of the bladder with no other intraoperative complications so far.Aveage time duration of the operation was 112 minutes.All patients were scheduled to be seen at 4 weeks, 6 months and 12 months after operation and then yearly therafter.The mean follow-up period was 16,8 months (6-27). We have achieved satisfactory results in 25 patients while 4 patients have bladder instability, 3 patients suffered from urinary infection, 2 have febrile morbidity and 2 bottock pain. Sacrospinous colpopexy can be performed together with vaginal hysterectomy and anterior and posterior vaginal wall repair in patients with marked uterovaginal prolapse because of its high success in avoiding possible vault prolapse and low intra and post-operative complication rates.

scholarly journals Application of transvaginal sacrospinous colpopexy in the treatment of pelvic organs prolapse

2005 ◽  
Vol 62 (9) ◽  
pp. 637-643 ◽  
Author(s):  
Rajka Argirovic ◽  
Ivana Likic-Ladjevic ◽  
Svetlana Vrzic-Petronijevic ◽  
Milos Petronijevic ◽  
Nebojsa Ladjevic
Keyword(s):  
Postoperative Complications ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Uterovaginal Prolapse ◽  
Complication Rates ◽  
Sacrospinous Ligament ◽  
Vault Prolapse ◽  
Sacrospinous Colpopexy

Introduction. The incidence of uterovaginal and vaginal vault prolapse appears to be higher due to the increased longevity of women. Sacrospinous ligament colpopexy is a surgery procedure which suspends the vagina up to the sacrospinous ligament and brings upper vagina over the levator plate. This technique is very useful for the primary treatment of uterovaginal prolapse in young women who want to preserve their fertility. The main aim of our study was to present the effectiveness of the us of this technique at our clinic, to investigate the possible intraoperative and postoperative complications of this technique, and to find out its effectiveness in the prevention of repeated vaginal vault prolapse. Methods. Patients were treated with sacrospinous colpopexy with uterine conservation, vaginal hysterectomy with simultaneous sacrospinous colpopexy or obliteration of the enterocele sac, and sacrospinous colpopexy. Follow-up examinations of the patients we performed at 4 weeks, 6 months and 12 months after the surgery and yearly thereafter. Results. Thirtyseven women were treated with sacrospinous ligament suspension of vaginal vault. The 5 women had vault prolapse following the hysterectomy (the 3 of then had abdominal, and the 2 vaginal hysterectomy), and another 32 women had the various degrees of uterovaginal prolapse. We obtained satisfactory results in 33 patients, in the 3 we noticed asymptomatic cystocele, and the 1 (2,7%) had partial vaginal vault prolapse six months after the surgery. With regard to postoperative complications, 3 patients had urination disturbance, 3 patients had urinary tract infection, 2 patients had febrile temperature, and the 2 patients had low back pain. Discussion. We performed sacrospinous fixation on the right side, and the postoperative results demonstrated no disturbance in vaginal axis and vault prolapse except in 1 patient. We had no intraoperative complications noted related to sacrospinous ligament colpopexy, such as the damage to the pudendal vessels and nerve, the sciatic nerve and rectum. The possibility of injury to the vessels and nearby nerves was preventid with the careful placement of suture through the sacrospinous ligament in the two fingerbreadths medial to its insertion in the ischial spine. In our series, we had 3 patients with conservation of the uterus. The 3 asymptomatic cystocele in our series were diagnosed 6 months after the operation. Our results were satisfactory, since we hade only one postoperative vault prolapse (2,7%). Conclusion. The results of numerous studies, as well as the results of our study, showed that transvaginal sacrospinous colpopexy could be performed along with vaginal hysterectomy and the anterior and posterior vaginal wall repair in the patients with uterovaginal prolapse because of its high success in the prevention of postoperative vaginal vault prolapse and the low intra- and postoperative complication rates. This operative technique is successful in prevention of repeated vaginal vault prolapse.

Sacrospinous Fixation for Treatment of Vault Prolapse and at the Time of Vaginal Hysterectomy for Marked Uterovaginal Prolapse

2004 ◽  
Vol 10 (4) ◽  
pp. 213-218 ◽  
Author(s):  
Agnaldo L. Silva-Filho ◽  
S??rgio A. Triginelli ◽  
Adm??rio S. Santos-Filho ◽  
Eduardo B. C??ndido ◽  
Paulo Traiman ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Uterovaginal Prolapse ◽  
Vault Prolapse ◽  
Sacrospinous Fixation

scholarly journals Prevention of vault prolapse in cases of procedentia using combined vaginal and laparoscopic approach for vault suspension: Agrawal’s technique

2020 ◽  
Vol 10 (1) ◽  
pp. 296
Author(s):  
Priti Agrawal ◽  
Rishi Agrawal ◽  
Jyotirmay Chandrakar
Keyword(s):  
Intraoperative Complications ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Complication Rates ◽  
Vault Prolapse ◽  
Duration Of Surgery ◽  
Vault Suspension ◽  
Average Operating ◽  
Average Operating Time

Background: The objective of the current study was to assess the need of vault suspension after completion of hysterectomy in all cases of procedentia to prevent vault prolapse and to reduce the operating time for sacrocolpopexy using combined vaginal and laparoscopic approach by two surgeons.Methods: A total of 25 women undergoing surgery for procedentia were included. After completion of hysterectomy the need for vault suspension was assessed intraoperatively. In all cases polypropelene mesh was fixed vaginally to the uterosacral and cardinal ligaments. Vaginal vault was closed vaginally. Laparoscopic surgeon did laparoscopic sacrocolpopexy (LSC). Intraoperative and post-operative complications were then evaluated.Results: Our average operating time was 35 minutes for vaginal hysterectomy and 15 minutes for LSC. The shorter duration of surgery was because mesh was fixed vaginally and trackers were used to fix the mesh to sacral promontory. Intraoperative complications like bladder, ureteric, bowel injuries and hemorrhage were nil in our series. Postoperative stay in hospital was uneventful and all cases were discharged on second postoperative day. Conversion rate to laparotomy was nil. All cases have completed follow up for 5 years with 100% subjective and objective improvement.Conclusions: Restoration of vagina to its normal anatomic position remains the most important fact to prevent vault prolapse. Our technique is very easy, less time taking with negligible complication rates.

scholarly journals Sacrospinous colpopexy versus McCall’s culdoplasty during vaginal hysterectomy in stage 3 and 4 prolapse for prevention of vault prolapse

2021 ◽  
Vol 10 (7) ◽  
pp. 2825
Author(s):  
S. S. Gulati ◽  
Samta Gupta ◽  
Neha Khan ◽  
Shelly Agarwal ◽  
Naima Afreen ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Bladder Injury ◽  
Rectal Injury ◽  
Sacrospinous Ligament ◽  
Vault Prolapse ◽  
Operative Complications ◽  
Sacrospinous Colpopexy ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Background: Pelvic organ prolapse is a common condition seen in women due to weakening of support of pelvic organs. Different surgical procedures have been adopted for suspension of vaginal vault during vaginal hysterectomy to restore vault to near normal anatomic position as preventive measures for vault prolapse. The aim of study was to compare the efficacy of the McCall’s culdoplasty and sacrospinous ligament colpopexy in stage 3 and 4 prolapse (POP-Q).Methods: This prospective study comprised 100 women presenting with stage 3 and 4 prolapse (POP-Q). They were divided into two equal groups of 50 each. The patients were randomized to undergo McCall’s culdoplasty (Group A) or sacrospinous ligament fixation (Group B) with vaginal hysterectomy based on note contained in an envelope comparative analysis was done, and patients were evaluated for intra-operative difficulties and immediate (48 hours) post-operative complications using SPSS-version 23 for statistical analysis. The patients were followed up at one month and one year to evaluate symptomatically and objectively.Results: In group A, patients with 3-degree prolapse 1 woman had hemorrhage and 1 woman had bladder injury intraoperatively. Whereas in group B, 5 women had hemorrhage and 1 woman had rectal injury intraoperatively. All complications were dealt successfully. No other major intra- and post-operative complications occurred.Conclusions: Vaginal hysterectomy with sacrospinous colpopexy resulted in better outcomes after surgery. Hence, it was concluded that unilateral or bilateral SSLF may be added to vaginal hysterectomy in patients of stage 3 or 4 prolapse.

A Novel Surgical Technique for Large Frontoencephalocele Management: The Mercy Ships Approach

FACE ◽  
2021 ◽  
pp. 273250162097932
Author(s):  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Gary Parker ◽  
Shaillendra A. Magdum ◽  
Mirjam Hamer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intraoperative Complications ◽  
Complication Rates ◽  
The Novel ◽  
Middle Income ◽  
Middle Income Countries ◽  
Lumbar Drain ◽  
Cerebral Herniation ◽  
Long Nose

Background: Large frontoencephaloceles, more common in low and middle-income countries, require complex reconstruction of cerebral herniation, elongated nose, telecanthus, and cephalic frontal bone rotation. Previously described techniques involve multiple osteotomies, often fail to address cephalad brow rotation, and have high complication rates including up to 35% mortality. This study presents a novel, modified, single-staged technique for frontoencephalocele reconstruction performed by Mercy Ships. This technique, which addresses functional and aesthetic concerns with minimal osteotomies, may help improve outcomes in low resources settings. Methods: Retrospective review was performed of patients who underwent frontoencephalocele reconstruction through Mercy Ships using the technique described. Patient data including country, age, gender, associated diagnoses, and prior interventions were reviewed. Intraoperative and post-operative complications were recorded. Results: Eight patients with frontoencephalocele (ages 4-14 years) underwent surgery with the novel technique in 4 countries. Average surgical time was 6.0 ± 0.9 hours. No intraoperative complications occurred. Post-operatively 1 patient experienced lumbar drain dislodgement requiring replacement and a second had early post-operative fall requiring reoperation for hardware replacement. In person follow-up to 2.4 months showed no additional complications. Follow-up via phone at 1 to 2 years post-op revealed all patients who be satisfied with surgical outcomes. Conclusions: Reconstruction of large frontoencephaloceles can be challenging due to the need for functional closure of the defect and craniofacial reconstruction to correct medial hypertelorism, long nose deformity, and cephalad forehead rotation. The novel surgical technique presented in this paper allows for reliable reconstruction of functional and aesthetic needs with simplified incision design, osteotomies, and bandeau manipulation.

scholarly journals A Retrospective Review of 589 Percutaneous Tracheostomies in a Canadian Community Teaching Hospital

2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Intraoperative Complications ◽  
Percutaneous Tracheostomy ◽  
Hospital Setting ◽  
Complication Rates ◽  
Safe Alternative ◽  
Neck Extension ◽  
Intraoperative Complication ◽  
Community Teaching

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.

scholarly journals Trends in Hysterectomy for Genital Prolapse: Rural Experience

2013 ◽  
Vol 7 ◽  
pp. CMRH.S10804 ◽  
Author(s):  
Shakuntala Chhabra ◽  
Manjiri Ramteke ◽  
Sonali Mehta ◽  
Nisha Bhole ◽  
Yojna Yadav
Keyword(s):  
Coming Out ◽  
Vaginal Hysterectomy ◽  
Preoperative Evaluation ◽  
Genital Prolapse ◽  
Uterovaginal Prolapse ◽  
Preoperative Treatment ◽  
Genital Tract Infection ◽  
Surgical Morbidity ◽  
Mortality And Morbidity ◽  
Abnormal Vaginal Bleeding

The present study was conducted to investigate the trends of vaginal hysterectomy for genital prolapse in last 20 years by analyzing case records of affected women. During the analysis period, 4831 women underwent hysterectomy; records of 4223 (87.5%) were available. Of these, 911 (21.6%), 2.7% of 34,080 gynecological admissions, had vaginal hysterectomy for genital prolapse (study subjects). Eighty percent women who had vaginal hysterectomy for genital prolapse were over 40 years of age; however, most of these women had had the disorder for years before they presented. Only 4 (0.4%) women had not given birth, 874 (96%) women had had two or more births, and 383 (42%) had had 5 or more births. Having given birth was the major factor responsible for genital prolapse. In all, 94.2% of women presented with something coming out of the vagina.” Some women presented with abnormal vaginal bleeding or pain in abdomen as the chief complaint although they had had uterovaginal prolapse for years. There was no mortality and morbidity decreased over the years. There has been no change in the rate of vaginal hysterectomy for genital prolapse over the years. Surgical morbidity decreased trend, possibly because of the preoperative, intraoperative, and postoperative precautions taken, especially preoperative treatment of urinary and genital tract infection. Attempts need to be made to have safe births and a healthy life style so as to prevent genital prolapse and in case it occurs, therapy to prevent progression so that major interventions like hysterectomy are averted. Meticulous preoperative evaluation and planned therapy help in reducing surgical morbidity, if surgery becomes essential.

scholarly journals Effect of wrist dorsiflexion on ultrasound-guided radial artery catheterisation using dynamic needle tip positioning technique in adult patients: a randomised controlled clinical trial

2021 ◽  
pp. emermed-2020-209504
Author(s):  
Qingyu Xiao ◽  
Dejiang Xu ◽  
Shaohui Zhuang
Keyword(s):  
Success Rate ◽  
Radial Artery ◽  
Adult Patients ◽  
Controlled Clinical Trial ◽  
Complication Rates ◽  
Success Rates ◽  
Time Duration ◽  
Positioning Technique ◽  
Randomised Controlled ◽  
Group D

BackgroundIt is generally recommended to keep the wrist joint mildly dorsiflexed during radial artery catheterisation. However, wrist dorsiflexion might decrease the success rate of radial artery catheterisation with dynamic needle tip positioning technique. Therefore, we assessed the success rates of two groups with or without wrist dorsiflexion by 5 cm wrist elevation in adult patients.MethodsThis randomised controlled clinical trial was performed between March and December 2018 in the First Affiliated Hospital of Shantou University Medical College, China. We recruited 120 adult patients undergoing major surgical procedures and randomly allocated them into two groups: dorsiflexion group (group D) and neutral group (group N). The primary outcome was first-attempt success rates of two groups. Secondary outcomes were overall success rates within 5 min; numbers of insertion and cannulation attempts; overall catheterisation time; duration of localisation, insertion and cannulation; and complication rates of catheterisation.ResultsFirst-attempt success rate was 88.3% in group D and 81.7% in group N (p=0.444). The overall success rate within 5 min was 93.3% in group D compared with 90.0% in group N (p=0.743). Numbers of insertion and cannulation attempts, overall catheterisation time, duration of localisation and insertion, and complication rates did not show a significant difference between the two groups. Cannulation time was longer in group N (35.68 s) than that in group D (26.19 s; p<0.05).ConclusionWrist dorsiflexion may not be a necessity for ultrasound-guided radial artery catheterisation using dynamic needle tip positioning technique in adult patients.Trial registration numberChiCTR1800015262.

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