Index

Laparoscopic Management of Prolapse and Stress Urinary Incontinence Nutan Jain

1: The Concept of Laparoscopic Management of Pelvic Floor Defects
- INTRODUCTION
- OLDER CONCEPT OF PELVIC FLOOR REPAIR
- NEWER CONCEPT OF PELVIC FLOOR REPAIR
2: Pelvic Anatomy
- INTRODUCTION
- ABDOMINAL WALL STRUCTURES
  - Deep Aspect of Anterior Abdominal Wall
  - Relevant Arteries of the Abdominal Wall
- SUPERFICIAL INTRAPERITONEAL ANATOMY
- PELVIC BRIM
- AVASCULAR SPACES OF THE PELVIS
- RETROPUBIC SPACE OF RETZIUS
- PARAVESICAL SPACE
- PARARECTAL SPACE
- VESICOVAGINAL AND RECTOVAGINAL SPACES
- PRESACRAL (RETRORECTAL) SPACE
- URETERS
- BLADDER
- UTERUS
- FALLOPIAN TUBES (OVIDUCTS)
- OVARIES
- PELVIC FLOOR
3: Pelvic Support Anatomy
- PELVIC FLOOR
- SUPPORT OF PELVIC ORGANS
- BONY PELVIS
  - Muscles of the Pelvic Floor (Fig. 3.7)
- THE PERINEUM: SUPPORT OF THE PELVIC OUTLET
- ENDOPELVIC FASCIA
- CARDINAL/UTEROSACRAL LIGAMENT COMPLEX
- PUBOCERVICAL FASCIA
- RECTOVAGINAL FASCIA
- THE LOWER VERTICAL AXIS
  - Urethral Support Anatomy and Mechanism of Continence
4: Gradation of Prolapse: The Pelvic Organ Prolapse Quantification (POPQ) System
- INTRODUCTION
  - Technique
5: Urodynamic Studies and Evaluation for Incontinence Surgeries
- INTRODUCTION
- MICTURITION DIARY
- PAD TEST
- UROFLOWMETRY (FIG. 5.1)
- URODYNAMIC STUDY
- VIDEO URODYNAMICS
- TYPES OF STRESS URINARY INCONTINENCE
- AMBULATORY URODYNAMICS
  - Urethral Pressure Profilometry (UPP)
- EMG
- SURGICAL DECISION-MAKING BASED ON URODYNAMIC STUDIES
6: Suturing Application in Pelvic Floor Repair Sliding Knots
- INTRODUCTION
- THE SLIDING SQUARE KNOT
- THE MODIFIED ROEDER KNOT
- THE WESTON KNOT
- KNOT PUSHERS
- CONCLUSIONS
7: Laparoscopic Extracorporeal Suturing
- INTRODUCTION
- EQUIPMENT
- INTRODUCTION OF SUTURE
- PLACEMENT OF LIGATURES
- EXTRACORPOREAL KNOT TYING
8: Intracorporeal Suturing
- INTRODUCTION
- EQUIPMENT
- NEEDLE HOLDERS
- PREREQUISITE FOR INTRACORPOREAL SUTURING
- BASIC TECHNIQUE
- ADJUSTING THE NEEDLE
- TECHNIQUE OF INTRACORPOREAL SUTURING
- TECHNIQUE OF INTRACORPOREAL KNOTS-TYING
- EXACT TECHNIQUE
- TIPS
- LOOSENING OF KNOT
- COMPLICATIONS OF LAPAROSCOPIC SUTURING
- CONCLUSION
9: Management of Stress Urinary Incontinence by TVT
- INTRODUCTION
10: TOT Sling for Stress Urinary Incontinence
- INTRODUCTION
- RISKS OF RETROPUBIC NEEDLE PASSAGE (Fig. 10.1)
- ADVANTAGES OF TRANSOBTURATOR APPROACH (Fig. 10.2)
- TRANSOBTURATOR ANATOMY (Figs 10.3A and B)
- TOT NEEDLE PASSAGE (FIGS 10.4A TO 10.5)
- TOT MIMICS NORMAL ANATOMY
- SURGICAL SYNOPSIS-TOT SLING (Figs 10.9 to 10.16)
- CLINICAL OUTCOMES
- OUTSIDE-IN SAFER THAN INSIDE-OUT APPROACH
- TIPS AND PEARLS (RARE COMPLICATIONS)
- CONCLUSIONS
11: Trocar Assisted Sling Suspension (TASS for Stress Urinary Incontinence
- INTRODUCTION
- SURGICAL TECHNIQUE
- DISCUSSION
12: Laparoscopic Paravaginal Repair and Burch Urethropexy
- INTRODUCTION
  - Equipments and Sutures
- POTENTIAL COMPLICATIONS AND INJURIES
  - Lower Urinary Tract Injuries
  - Vascular Injuries
- CONCLUSION
13: Reich Modification of the McCall Culdoplasty for Prevention and/or Repair of Prolapse during Total Laparoscopic Hysterectomy (Without Mesh, Please!)
- INTRODUCTION
- CONCLUSION
14: Sacrospinous Colpopexy
- INTRODUCTION
- ANATOMICAL CONSIDERATIONS
- CLINICAL USEFULNESS OF THE SS LIGAMENT
- TECHNICAL ASPECTS OF THE SS LIGAMENT FIXATION
- UNILATERAL OR BILATERAL PEXY
- COMPLICATIONS
- POSTOPERATIVE CARE
- PERSONAL EXPERIENCE
- CONCLUSIONS
15: The Role of Mesh in Pelvic Floor Reconstruction
- INTRODUCTION
- AIM OF MESH REPAIR
- DYNAMICS OF MESH
- TYPES OF MATERIAL
- IDEAL MATERIAL
- RECOGNIZING THE PROBLEM AND MANAGEMENT
- CONCLUSION
16: Laparoscopic Sacralcolpopexy and Enterocele Repair with Mesh
- INTRODUCTION
- ANATOMY OF PELVIC SUPPORT
  - Endopelvic Fascia
- LEVEL 1—APICAL SUPPORT
- LEVEL I SUPPORT—LAPAROSCOPIC APPROACH TO ENTEROCELE REPAIR AND VAGINAL VAULT SUSPENSION
- LEVEL 1 SUPPORT PROCEDURES: CLINICAL RESULTS
- CONCLUSION
17: Laparoscopic Treatment of Genital Prolapse: Lateral Suspension Using a Mesh
- INTRODUCTION
- CLINICAL APPLICATION
- INSTRUMENTS AND SUTURE MATERIAL REQUIRED
- PORT PLACEMENT
- OPERATIVE TECHNIQUE
- ASSOCIATED PROCEDURE
- PITFALLS/ SPECIAL POINTS TO BE HIGHLIGHTED
- SUGGESTED POINTS WHERE BEGINNER CAN STUCK AND HOW TO GET OUT OF IT
- DISCUSSION
18: Prolapse Repair in Young Patients of Reproductive Age Group
- ANATOMY OF PELVIC SUPPORT
- SIMPLE MESH TECHNIQUE
- SURGICAL TECHNIQUE
- TECHNIQUE OF REPAIR WITHOUT USE OF MESH
- CONCLUSION
19: Laparoscopic Management of Significant Uterovaginal Prolapse
- INTRODUCTION
- PRINCIPLES OF PELVIC FLOOR RECONSTRUCTION
- INSTRUMENT, SUTURES AND MESH
- TREATMENT OF PROLAPSE COMPRISES THREE PHASES
  - Technique
  - Posterior Dissection
- PREPARATION OF THE PROMONTORY
- PROMONTOFIXATION
- COMPLICATIONS
  - Complications with use of Mesh, Prevention and Management
  - Complications Following Sacrocolpopexy
- RESULTS
- CONCLUSION
20: Laparoscopic Uterosacral Uterine Suspension(LUSUS)
- INTRODUCTION
- LITERATURE REVIEW
- TECHNIQUE
- POSTOPERATIVE CARE
- CONCLUSIONS
21: Laparoscopic Site Specific Repair for Pelvic Organ Prolapse (Without Use of Mesh)
- INTRODUCTION
- PELVIC FLOOR
- ENDOPELVIC FASCIA
- THE ANTERIOR COMPARTMENTS
- THE MIDDLE COMPARTMENT
- THE POSTERIOR COMPARTMENT
- CONCLUSION
  - Sutures, Needle and Needle Holders
- COMPLICATIONS
22: Current Concepts in Rectocele Repair
- INTRODUCTION
- PHYSICAL EXAMINATION
- DIAGNOSTIC TESTING
- POSTERIOR COLPORRHAPHY (TRADITIONAL)
- SITE-SPECIFIC DEFECT REPAIR
- GRAFT AUGMENTATION (TABLE 22.3)
- PERINEORRHAPHY
- ABDOMINAL SACRAL COLPOPEXY (COLPOPERINEOPEXY)
- LAPAROSCOPIC RECTOCELE REPAIR
- POSTOPERATIVE INSTRUCTIONS
- COMPLICATIONS
- ANALYSIS OF OUTCOMES
23: Laparoscopic Approach to Genitourinary Fistulae in Women
- INTRODUCTION
- VESICOVAGINAL FISTULA
- URETEROVAGINAL FISTULA
  - Ureteroscopic Management (Figs 23.4A to F)
  - Ureteric Reimplantation/Boari Flap (Figs 23.5A to M)
- VESICOUTERINE FISTULA
- CONCLUSION
24: Practical Cystoscopy for Gynecologist
- INTRODUCTION
- TYPES OF CYSTOSCOPE
- HISTORY
  - Rigid Endoscope
- FLEXIBLE ENDOSCOPES (FIG. 24.4)
- ENDOSCOPIC EQUIPMENT
- CARE AND STERILIZATION OF INSTRUMENTS
  - Decontamination
- STERILIZATION
  - Steam
  - Gas
- DISINFECTION
  - Cold Soak
  - Automated Soak
- INDICATIONS FOR CYSTOSCOPY
  - As in Adjunct to Gyne Surgery
- TECHNIQUE
  - Cystoscopy Boat
    - Anesthesia
- DESCRIPTION OF THE PROCEDURE
- COMPLICATION OF THE PROCEDURE
  - Remedial Steps for Complications of the Procedure
- RISK FACTORS FOR CYSTOSCOPY
- POSTCYSTOSCOPY CARE
- CONCLUSION
25: Newer Concepts in Vaginal Procedures in Reconstructive Surgery
- POSTERIOR VAGINAL PROLAPSE—POSTERIOR COLPORRHAPHY USING THE “FASCIAL REPAIR” TECHNIQUE
- POSTERIOR VAGINAL PROLAPSE—SITE-SPECIFIC REPAIR (SEE ACCOMPANYING OPERATIVE DVD)
- ANTERIOR VAGINAL PROLAPSE
  - Preamble
- ANTERIOR COLPORRHAPHY WITH VAGINAL SKIN GRAFT (REFER TO OPERATIVE DVD)
- SITE-SPECIFIC ANTERIOR REPAIR WITH SURGISIS® ESTM REINFORCEMENT
- ANTERIOR REPAIR WITH PERMANENT MESH
- APICAL COMPARTMENT REPAIR
- SACROSPINOUS FIXATION
- MESH-KIT REPAIR OF APICAL PROLAPSE
- MESH-KIT REPAIR OF GLOBAL PROLAPSE
- POSTOPERATIVE ORDERS—OUR STANDARD PROTOCOL FOR ALL PELVIC RECONSTRUCTIVE PROCEDURES
- CONCLUSION
26: Interstitial Cystitis in 2007
- INTRODUCTION
- DEFINITION
- PROPOSED PATHOPHYSIOLOGY OF INTERSTITIAL CYSTITIS
- SYMPTOMS
- PHYSICAL EXAMINATION
- INVESTIGATIONS
  - Copenhagen Cystoscopic Classification of Bladder Mucosa (May 2003)
- SCREENING AND DIAGNOSTIC TOOLS
- URINARY MARKERS
- TREATMENT
- INTRAVESICAL COCKTAILS (RESCUE SOLUTIONS)
- DISEASE UNDERDIAGNOSED
- CHANGE OF NOMENCLATURE
- INTERSTITIAL CYSTITIS IN CHILDREN
- CONCLUSION
27: Complications of Transvaginal Tape (TVT)
- INTRODUCTION
- TECHNICAL STEPS AND ITS IMPORTANCE
- MAJOR COMPLICATIONS
  - Bleeding/Hemorrhage
  - Perforation of Bladder
- RETENTION OF URINE (Table 27.2)
- BOWEL PERFORATION (Fig. 27.4)
- MINOR COMPLICATIONS
  - Voiding Dysfunction
- EROSIONS
  - Urethral Erosion (Tables 27.4 and 27.5)
- RETENTION
- RECURRENCE OF SUI
- RECURRENT URINARY TRACT INFECTION
- THROMBOEMBOLISM
  - 65-YEAR-OLD POST-TVT
  - POST-TVT VESICOVAGINAL FISTULA
- NEUROLOGICAL INJURIES
- CELLULITIS ABSCESS FORMATION

INDEX

TOC
Index

Chapter Notes