Grigoriadis Themos, Protopapas Athanasios, Chatzipapas Ioannis, Athanasiou Stavros
First Department of Obstetrics and Gynecology, Urogynecology Unit, National and Kapodistrian University of Athens, "Alexandra" Hospital, 105-107 Vas. Sofias Avenue, Athens, 11521, Greece,
Int Urogynecol J. 2015 Mar;26(3):449-50. doi: 10.1007/s00192-014-2541-4. Epub 2014 Oct 23.
Women with complete uterovaginal prolapse (UVP) present multicompartmental pelvic defects. The vaginally assisted laparoscopic sacrocolpopexy (VALS) has been introduced to address such defects by combining a vaginal and a laparoscopic approach.
This is a video demonstration of a VALS procedure performed on a 60-year-old patient with a complete UVP. The presented procedure comprises two steps: an initial vaginal surgery, followed by a laparoscopic approach. The vaginal surgery initially includes a vaginal hysterectomy and full-thickness dissection of the vaginal walls. The meshes are then sutured on the fascias and the free ends are placed in the pelvic cavity. The vaginal vault is closed transvaginally and then suspended laparoscopically on the sacral promontory.
The VALS procedure is a valid minimally invasive surgical alternative for patients with severe or complete UVP. This combined procedure facilitates the surgical steps and minimizes the need to perform difficult pelvic laparoscopic dissections.
患有完全性子宫阴道脱垂（UVP）的女性存在多腔室盆腔缺陷。阴道辅助腹腔镜骶骨阴道固定术（VALS）已被引入，通过结合阴道和腹腔镜方法来解决此类缺陷。
这是对一名60岁完全性UVP患者进行VALS手术的视频演示。所展示的手术包括两个步骤：首先是阴道手术，然后是腹腔镜手术。阴道手术最初包括阴道子宫切除术和阴道壁全层剥离。然后将网片缝合在筋膜上，其自由端置于盆腔内。经阴道关闭阴道穹窿，然后在腹腔镜下将其悬吊于骶骨岬上。
VALS手术是重度或完全性UVP患者有效的微创手术替代方案。这种联合手术简化了手术步骤，并最大限度地减少了进行困难盆腔腹腔镜解剖的必要性。
