Laparoscopic Hysterectomy
RATIONALE FOR APPROACH Print Section Listen The first laparoscopic hysterectomy was performed by Dr Harry Reich in 1988.1 Since then, 12% to 14% of hysterectomies for benign disease in the…
Apical Procedures
APICAL PROCEDURES Print Section Listen Introduction and Indications Restoring apical support is increasingly recognized as an essential component of any surgical procedure for pelvic organ prolapse. Although the anterior vaginal…
Vaginal Hysterectomy with Uterosacral Plication
Print Section Listen Several techniques may be utilized to perform a hysterectomy in the setting of pelvic organ prolapse. Vaginal hysterectomy, the most commonly employed technique, will be the focus…
Complications from Pelvic Reconstructive Surgery
BLADDER INJURY Print Section Listen The bladder may be lacerated during a hysterectomy, pelvic prolapse repair, or other pelvic surgery. A bladder cystotomy can occur during transvaginal, transabdominal, or laparascopic…
Anal Incontinence
INTRODUCTION Print Section Listen Anal incontinence (AI) is defined as the involuntary loss of flatus, liquid, or stool that is a social and hygienic problem.1 It remains a complex and…
Fistula Repair
Print Section Listen Obstetric fistula (OF), although virtually eradicated from the developed world, has a number of unique features that make this topic worthy of the attention of practitioners of…
Stress Urinary Incontinence
MIDURETHRAL SLINGS: RETROPUBIC MIDURETHRAL SLING Print Section Listen For many years, gynecologic surgeons awaited a primarily vaginal procedure that yielded cure rates and low complications comparable to the Burch colposuspension….
Posterior Compartment Surgery
INTRODUCTION Print Section Listen Posterior vaginal wall prolapse includes rectoceles, enteroceles, and sigmoidoceles and often occurs in combination with other pelvic support problems. Isolated rectoceles are quite rare. Figures 33-1…
Anterior Compartment Surgery
ANTERIOR REPAIR Print Section Listen Anterior repair, or anterior colporrhaphy, is utilized to surgically correct a cystocele caused by a central defect in the endopelvic fascia. This can be accompanied…
Instrumentation
Print Section Listen Pelvic reconstructive surgery involves a variety of surgical approaches including vaginal, laparoscopic, robotic, and abdominal. Each different surgical approach poses unique challenges for the gynecologic surgeon. Vaginal…
