期刊
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
卷 -, 期 -, 页码 -出版社
WILEY
DOI: 10.1111/1471-0528.17030
关键词
Hypogastric nerve; pelvic organ prolapse; presacral space; sacrocolpopexy; transvaginal natural orifice transluminal endoscopic surgery
This study describes the standard practice of presacral exposure during vNOTES for sacrocolpopexy in women with uterine prolapse, including key techniques such as identifying nerves, removing tissue, incising fascia, attaching mesh, and completing peritonealisation.
We describe the standard practice of presacral exposure during transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for sacrocolpopexy in women with uterine prolapse. In this video, we demonstrate the key techniques: identifying the right hypogastric nerve (rHN) before opening the pelvic peritoneum; removing the fat and loose connective tissue along the rHN to expose the presacral fascia; incising the presacral fascia to reach the presacral space to expose the middle sacral vasculature and the anterior longitudinal ligament (ALL) of the first sacral vertebra (S1) below the promontory; attaching the mesh to the ALL to avoid vessel injury; and completing the peritonealisation.
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