Sacrospinofixation of Richter in 8 points: original contribution of the laparoscopic column in the visualization of the sacrospinous ligaments

Publication date: Available online 3 May 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Marie ZILLIOX, Lise Lecointre, Thomas Boisramé, Cherif AkladiosAbstractStudy ObjectiveAlthough the standard technique is currently based on laparoscopic promontofixation, the standard vaginal technique for the treatment of uterine prolapse is sacrospinofixation according to Richter 1, 2, 3. Described by Kurt Richter in 1968, this intervention corrects the middle floor and consists of fixing the vaginal dome (after hysterectomy or not) on the sacrospinous ligament(s) 4, 5. The technique includes a wide dissection of the pararectal fossa, using several Breisky's valves, to grip the sacrospinous ligament under strict visual control. This crucial step of the intervention implies an optimal visual control for the operator, but does not allow the visual access to the operative assistants, which is regrettable for the purpose of teaching 2, 4, 5, 6.The aim of this surgical video is to describe the different stages of the sacrospinofixation surgical technique, showing sacrospinous ligaments during the crucial step, thanks to a laparoscopic camera.DesignA step-by-step explanation of the surgery using video (instructive video) approved by the local ethics committee.SettingGynecological Surgery Unity, University Hospital of Strasbourg, FrancePatientsA 70-year-old woman with multicompartment pelvic organ prolapse.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research