Efficacy of a standardized technique of trans-vaginal entry into the peritoneal cavity for post-hysterectomy vaginal vault suspension.
The aim of this paper is to describe the efficacy and safety of a standardized technique of trans-vaginal entry into the peritoneal cavity for post-hysterectomy vault prolapse and determine how well the pre-operative pelvic examination predicted successful peritoneal entry. A retrospective review of patients undergoing post-hysterectomy trans-vaginal apical suspensions using a standardized technique of peritoneal entry was employed in this study. A subset of patients underwent a standardized pre-operative evaluation to predict what organ was behind the vaginal cuff and posterior cul-de-sac. Peritoneal entry was attempted in 280 patients, and successfully achieved in 223(80%). One cystotomy and one proctotomy (0.3%) occurred during attempted entry. Of those who underwent the standardized pre-operative evaluation, peritoneal entry was successful 86% of the time when small bowel was predicted to lie behind the vaginal cuff or posterior cul-de-sac. Peritoneal entry can be safely achieved in the majority of post-hysterectomy prolapse patients. Pre-operative examination assists in predicting successful peritoneal entry.
Duke Scholars
Published In
DOI
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Related Subject Headings
- Vagina
- Uterine Prolapse
- Treatment Outcome
- Retrospective Studies
- Reoperation
- Postoperative Complications
- Plastic Surgery Procedures
- Peritoneal Cavity
- Obstetrics & Reproductive Medicine
- Middle Aged
Citation
Published In
DOI
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Vagina
- Uterine Prolapse
- Treatment Outcome
- Retrospective Studies
- Reoperation
- Postoperative Complications
- Plastic Surgery Procedures
- Peritoneal Cavity
- Obstetrics & Reproductive Medicine
- Middle Aged