Tension-free vaginal tape
by Robert D Moore, John R Milkos

State of the Art Atlas of Endoscopic Surgery in Infertility and Gynecology

by Nutan Jain
About Video

In this video local anesthetic agent injected into vaginal mucosa and submucosal tissues in the midline and bilaterally at the level of the midurethra toward the bladder neck and in direction of retropubic space. Once incision and dissection complete, then local anesthesia is injected bilaterally with a spinal needle along the tract the TVT needle will take, i.e. through the pubocervical fascia and then up into retropubic space right behind pubic bone. The edges of the vaginal incision grasped with Adair clamps and minimal dissection is used to free the vaginal wall from the suburethral tissues and develop a small tunnel paraurethrally bilaterally. The pubocervical fascia is not broken through. Dissection is completed sharply with Metzenbaum scissors, blunt dissection utilizing fingers should not be completed. Re-usable TVT handle is inserted on needle preparing for passage. Speculum is removed from vagina.

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