FROM THE 15TH INTERNATIONAL CONGRESS AND ENDO EXPO
LAPAROSCOPY UPDATE: ABDOMINAL/PELVIC PAIN/ADHESIONS
CONRAD DUNCAN, MD
Members of SLS support both the application of minimally invasive innovations as well as the application of evidenced-based medicine in our surgical practices.
In the past 10 years, urologists and gynecologists have witnessed the introduction and widespread adoption of the use of synthetic mesh in the management of patients with stress urinary incontinence (SUI). The introduction of the Tension Free Vaginal Tape‚ essentially revolutionized the treatment of SUI. “Long term” (10 yr) data has shown the tension-free mid-urethral sling to be a relatively safe and efficacious minimally invasive treatment option for SUI.
We are now witnessing the propagation of the use of synthetic mesh in the correction of a wide range of vaginal vault defects including total uterine prolapse. Surgical application of mesh for the repair of pelvic organ prolapse has been based on theoretical principles, extrapolation from the general surgery literature, industry sponsorship and surgeon preference, as we do not yet have evidence-based data to support their widespread use. Yet, many pelvic reconstructive surgeons have embraced their application as an even more minimally invasive alternative than laparoscopic pelvic reconstruction.
We will review the anatomical and surgical principles involved in the placement of a total vaginal mesh, review the surgical technique in video and review some of the preliminary surgical outcomes data.
www.Laparoscopy.org The Laparoscopic Surgery Information Source