Laparoscopic techniques for vaginal vault prolapse

OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE Dr. Pradeep Garg Assistant Professor Obstetrics & Gynaecology, All India Institute of Medical Sciences New Delhi-110029

Incidence ,[object Object],[object Object]

Etiology ,[object Object],[object Object],[object Object]

Operations for nulliparous prolapse ,[object Object],[object Object],[object Object],[object Object]

Aim/Advantages of conservative surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conservative surgery ,[object Object],[object Object],[object Object],[object Object]

Abdominal Sling operations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Abdominal Sling operations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Shirodkar’s sling ,[object Object],[object Object]

SHIRODKAR’S SLING OPERATION (1960)

Purandare’s cervicopexy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PURANDARE’s CERVICOPEXY (1965)

Khanna’s sling operation ,[object Object],[object Object]

Khanna’s Posterior sling operation (1972)

Joshi’s Sling ,[object Object]

Virkud’s composite sling operation ,[object Object],[object Object]

Virkud’s Sling ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Soonawala’s Sling ,[object Object]

Ureter Video To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Sacrocervicopexy Video To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Sacrocervicopexy Video ,[object Object],To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Sacrocervicopexy ,[object Object],[object Object],[object Object],[object Object]

Nulliparous Prolapse Shirodker’s + Khanna’s Cervicopexy Video To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Laparoscopic Cervicopexy/sling Operations ,[object Object],[object Object],[object Object]

Laparoscopic surgery prolapse ,[object Object],[object Object]

Vaginal vault prolapse ,[object Object]

Etiology ,[object Object],Fig-1 Fig-2

Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management Prolifit and Apogee Mesh Sacrocolpopexy Uterosacral suspension Sacrospinous fixation Paravaginal repair Laparoscopic Posterior intravaginal singplasty Tape Zacharin’s procedure Abdominoperineal Abd Uterosacral suspension Sacrocolpopexy Rectus sheath colpopexy Abdominal Sacrospinous/iliococcygeous fixation Uterosacral suspension Le fort operation Colpocliesis/colpectomy/vaginectomy Vaginal

Mesh ,[object Object],[object Object],[object Object],[object Object]

Final position of the Mesh in Pelvis

Final position of the Mesh in Pelvis (Side view) Video

Advantages of Laparoscopic approach ,[object Object],[object Object],[object Object],[object Object],[object Object]

Complications of Laparoscopic Approach ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications of Laparoscopic Approach…

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications of Laparoscopic Approach…

Vascular pelvic anatomy Video To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Are laparoscopic procedure recommended ? ,[object Object],[object Object],[object Object]

Sacrospinous Ligament Suspension ,[object Object]

Vaginal Sacrospinous fixation Video To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Abdominal sacrocolpopexy Vs Sacrospinous fixation ,[object Object]

Unilateral Vs bilateral Sacrospinous fixation ,[object Object]

Abdominal sacrocolpopexy Vs Sacrospinous fixation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laparoscopic uterosacral suspension Video To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims

Iliococcygeal vaginal suspension ,[object Object]

Iliococcygeus fixation ,[object Object]

Vault suspention to ant abd wall ,[object Object],[object Object],[object Object],[object Object],[object Object]

Time has come for Laparoscopic Surgery for Prolapse So move with the times. Practice laparoscopy. This is the Surgery of the future today.

Prevention of vault prolapse at the time of hysterectomy ,[object Object],[object Object],[object Object],[object Object]

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Laparoscopic techniques for vaginal vault prolapse

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Laparoscopic techniques for vaginal vault prolapse