Atlas of Urogynecologic Surgery PDF+VIDEO’s 2020 15€

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Video Contents*

Video 6.1: Uterosacral ligament suspension procedure: Placing the uterosacral sutures.
Video 17.1: The procedure of intravesicular injection.
Video 22.1: Anterior abdominal wall landmarks: The insertion of the round ligament, followed by identification
of the obliterated umbilical artery (also referred to as the medial umbilical ligament) help to facilitate location
of the inferior epigastric vessels lateral to these structures. Lateral trocars should be placed lateral to the inferior
epigastric vessels under direct visualization with the laparoscope with care to avoid injury to these vessels.
Video 22.2: Optimal trocar placement: This video illustrates a correctly placed trocar that has not been tracked
along the fascia. Note the 90° angle between the trocar and the anterior abdominal wall, optimizing trocar movement during surgery.
Video 22.3: Suboptimal trocar placement: This video illustrates a trocar that has been tracked along the fascia. Note
the less than 90° angle between the trocar and anterior abdominal wall resulting in suboptimal trocar movement
during surgery.
Video 25.1: Dissection and identification of anal sphincter.
Video 25.2: Repair of chronic third degree laceration, overlapping repair.
Video 26.1: Vaginal sling removal.

Contents

SECTION 1: PRE-SURGICAL PREPATATION
1. Surgical Decision-making and Patient Preparation for the Operating Room 3
Tajnoos Yazdany
• Antibiotics 3
• Patient Skin Preparation 4
• Bowel Preparation 4
• Deep Vein Thrombosis Prevention 4
• Unique Considerations in the Elderly Patients 4
• The Consent Process and Patient Understanding 4
SECTION 2: PATIENT POSITIONING FOR OPEN, VAGINAL,
LAPAROSCOPIC AND ROBOTIC SURGERY
2. Patient Positioning for Open, Vaginal, Laparoscopic and Robotic Surgery 9
Joy Brotherton, Erica Stockwell
• Universal Precautions and Preoperative Considerations 9
• Laparotomy 10
• Vaginal 10
• Laparoscopic 11
• Surgeon Ergonomics 12
• Robotic 13
SECTION 3: GENERAL VAGINAL AND VULVAR PROCEDURES
3. Hysterectomy, Salpingectomy and Oophorectomy through the Vaginal Route 17
Tajnoos Yazdany
• Vaginal Hysterectomy 17
– Difficult Cases 19
• Salpingectomy/Oophorectomy 20
4. Vaginal Cysts 22
Christina M Truong, Tajnoos Yazdany
• Preoperative Planning 22
– Gartner’s Duct 22
– Bartholin’s Gland 22
5. Labioplasty of the Labia Minora 27
Christina M Truong
• Preoperative Considerations 27
• Surgical Procedure 27

SECTION 4: VAGINAL SURGERY FOR APICAL
PELVIC ORGAN PROLAPSE
6. Uterosacral Ligament Suspension 33
Sharon Jakus-Waldman
• Surgical Procedure and Technique 34
7. Sacrospinous Ligament Fixation 37
Tajnoos Yazdany
• Surgical Procedure 38
8. Colpocleisis 40
Christina M Truong
• Obliterative Vaginal Procedures 40
9. Uterine Suspension Procedures 44
Jessica S Zigman
• Transvaginal Procedures 44
• Abdominal or Laparoscopic or Robotic-Assisted Procedures 45
SECTION 5: VAGINAL SURGERY FOR ANTERIOR AND
POSTERIOR COMPARTMENT PROLAPSE
10. Anterior Vaginal Wall Repair 55
Tajnoos Yazdany
• Surgical Procedure 55
11. Posterior Repair Techniques and Perineorrhaphy 59
Cecilia K Wieslander
• Surgical Procedure 59
SECTION 6: URINARY INCONTINENCE PROCEDURES
12. Mid-Urethral Slings 65
Gregory I Kanter, Gena Dunivan
• Retropubic Mid-urethral Slings: ‘Bottom-Up’ and ‘Top-Down’ Approach 66
• Transobturator Tape: ‘Outside to In’ and ‘Inside to Out’ Technique 71
13. Burch Urethropexy 76
John N Nguyen
• Operative Setup 76
• Surgical Procedure 76
14. Urethral Bulking 80
Aldene O Zeno, Amy Rosenman
• Patient Counseling 80
• Operative Setup 80
• Periurethral versus Transurethral Injection 81
Contents xvii
15. Fascial Slings 84
John Navas, Cecilia K Wieslander
• Surgical Procedure 84
16. Neuromodulation 87
Angel M Johnson, Patricia Hudson, Milena M Weinstein
• Percutaneous Nerve Stimulation 87
• Sacral Nerve Neuromodulation 88
17. Intravesicular Injection of OnabotulinumtoxinA 95
Tajnoos Yazdany
• Preoperative Assessment and Counseling 95
• Surgical Procedure 95
SECTION 7: OTHER URETHRAL PROCEDURES
18. Urethrovaginal Fistula Repair 99
Janine Oliver, Ja-Hong Kim
• Etiologies and Patient Assessment 99
• Diagnostic Considerations 99
• Timing of Repair 99
• Tissue Interposition 100
• Step-by-Step Technique 100
• Techniques for Severe and Salvage Cases 105
19. Urethral Diverticulum 108
Christina M Truong
• Preoperative Considerations 108
• Surgical Procedure 109
SECTION 8: BLADDER PROCEDURES AND REPAIRS
20. Vesicovaginal Fistula 115
Tam Le
• Operative Setup 115
• Vaginal Repair 115
• Abdominal Repair 119
21. Bladder Hydrodistention 123
Tajnoos Yazdany
• Cystoscopy with Hydrodistention 123
SECTION 9: LAPAROSCOPIC AND ROBOTIC APPROACHES
22. Surgical Considerations: Anatomy and Port Placements 127
Joy Brotherton, Chirisse Taylor, Erica Stockwell
• Primary Laparoscopic Trocar Placement 127
• Secondary Trocar Placement 130
xviii Atlas of Urogynecologic Surgery
• Robotic-Assisted Laparoscopy 130
• Removal of Trocars and Closure of Trocar Sites 134
23. Sacral Colpopexy 136
Tajnoos Yazdany
• Surgical Procedure 136
SECTION 10: FECAL INCONTINENCE PROCEDURES
24. Anovaginal and Rectovaginal Fistula 143
Tajnoos Yazdany
• Surgical Procedure 143
25. Anal Sphincteroplasty for Chronic Third Degree Lacerations 145
Christina C Liao
• Surgical Procedure 145
SECTION 11: DEALING WITH POSTOPERATIVE MESH
COMPLICATIONS
26. Transvaginal Tape Removal/Loosening 153
Sylvia M Botros-Brey, Carolyn Botros
• Urinary Retention 153
• Mesh Exposure Requiring Partial Removal 154
• Complete Removal of Mesh 154
• Erosion into Bladder or Urethra 154
27. Treatment of Mesh in the Bladder 156
Christina Dancz
• Step-by-Step Techniques (Abdominal Approach) 156
• Step-by-Step Techniques (Vaginal Approach) 157
28. Surgical Management of Vaginal Mesh Exposures 160
Christina Dancz
• Step-by-Step Techniques 160
Index 163