Abstract

INNOVATIVE TECHNIQUE OF LAPAROSCOPIC SACROCERVICOPEXY

*Gp Capt J.C. Sharma and Dr. Rupa Talukdar

Abstract

Aim: To study the effectiveness of an innovative technique devised for performing sacro-cervicopexy procedure and provide necessary support to uterine prolapse with very economical material – no 5 Ethibond suture [Poly ethylene terephthalate]. Material and method: Women with prolapsed uterus were selected, prolapse of central compartment with a Pelvic Organ Prolapse Quantitative (POP-Q) stage 2. A graft was prepared aseptically with no 5 Ethibond suture in the operation theatre before commencement of surgery. The presacral space, including the common iliac arteries and the middle sacral vessels, identified. The incision in the peritoneum began from the presacral area at sacral promontory and was carried caudally into the elvis, lateral to the rectosigmoid, and medial to the right uterosacral ligament. Anteriorly uterovesical peritoneal fold was opened laterally into the broad ligament. The needle with the graft is passed from posterior aspect of left broad ligament through a avascular window close to the uterus. The needle is now taken in front of the uterus and then passed through a avasular window in the right broad ligament. The needle is then passed through the graft thus putting a reef knot; anchoring around the cervix. Then the uterus is pulled upto desirable elevated uterine position by vaginal manipulation. The suture anchors the graft to the anterior longitudinal ligament of the sacral promontory. Results: The post operative recovery was very smooth and the descent of the uterus was corrected. Post -surgery follow up for two years revealed very high patient satisfaction and no recurrence of prolapse. Conclusion: The innovative technique of sacrocervicopexy is effective and economical and very satisfactory to patient.

Keywords: Sacrocervicopexy, laparoscopic, innovative technique.