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PelvicOrganReconstructive Surgery
- 1. PelvicOrganReconstructive Surgery With compliments Andri Nieuwoudt Applying the Flagpole Concept in POR surgery
- 2. Requirements of the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability
- 4. Requirements of the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability = Temporary Scaffold = Semi-permanent Scaffold = Permanent solid support flag pole
- 5. Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole The flag
- 6. Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole The flag
- 7. Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole
- 8. Requirements of the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability = Temporary Scaffold = Semi-permanent Scaffold = Permanent solid support flag pole biomesh Synthetic mesh
- 9. The Damage to the Rectovaginal septum The breaking of the POLE
- 11. With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 12. rugae With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com Photo`s and slide by dr Richard Reid Recto-enterocele Linear EPF tear Enterocele defined Enterocele sac
- 15. Repairing the Posterior compartment
- 17. With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com Photo`s and slide by de Richard Reid Recto-enterocele Linear EPF tear Enterocele defined Enterocele sac
- 20. Sacro-spinous lig Sacro-spinous lig
- 22. Requirements the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability = Temporary Scaffold = Semipermanent Scaffold = Permanent solid support flag pole Biomesh (SIS) Synthetic mesh
- 23. With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 24. Repairing the anterior compartment
- 25. 1.Enter superficial Anterior Vaginal wall cleavage plain 1.Insnijding in de natuurlijke spatie in de vaginale voorwand With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 27. Blaaskatheter Catheter Vaginal wall Bladderwall With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 28. 2. Penetrate attenuated lateral septum 2. Doodringen van zijwand scheiding tussen voorwand en zijde van bekken. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 29. bladder vagina Paravaginal disection
- 30. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 31. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 32. Cauterization of veins With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 33. 3. Sweep Bladder (& Ureter) medially 3. Stroop blaas en urineleider na binnen ( weg van de bekkenzijwand) With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 34. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 35. 4. Place 4 pairs of stay sutures in Whiteline or Obturator membrane 4. 4 hechtingen paren worden door whiteline of binnen membraan van bekkenwand geplaatst With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 37. Cervix Symphysis Whiteline Sutures baarmoederhals schaambeen With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 38. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 39. 5. Reconstruct “ trampoline” with SIS from whiteline to whiteline from Symphysis to cervix 5. Reconstructie van kapotte ondersteuning van de blaas met SIS van whiteline tot whiteline (zijwanden) van schaambeen tot baarmoederhals. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 40. bladder vagina
- 41. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 42. Symphysis pubis Cervix schaambeen baarmoederhals With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
- 43. Break PelvicOrgan supports up into different “organs” The Flagpole concept Baie dankie vir u aandag With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com