Manodoro Stefano, Frigerio Matteo, Milani Rodolfo, Spelzini Federico
AUSL della Romagna - Ospedale Infermi, Rimini, Italy.
U.O. Ostetricia e Ginecologia, AUSL della Romagna - Ospedale Infermi, Viale Luigi Settembrini 2, 47923, Rimini, RN, Italy.
Int Urogynecol J. 2018 Jan;29(1):161-163. doi: 10.1007/s00192-017-3497-y. Epub 2017 Oct 16.
Uterosacral ligament (USL) suspension is an effective and versatile surgical technique for repairing pelvic organ prolapse. However, ureteral injury is a feared complication that may act as a significant deterrent to the use of USL suspension. The aim of the video is to provide key steps to minimize the risk of ureteral injury while achieving successful transvaginal USL suspension.
The featured video provides a series of surgical tips and tricks that can be applied to protect the ureters while achieving USL suspension whether the procedure contemplated is vaginal hysterectomy, vaginal vault repair after hysterectomy, or hysteropexy.
The tips and tricks are classified into four categories: identification of the USLs, identification of the ureters, passage of the sutures, and final measures.
The USL suspension technique requires adequate surgical training and an understanding of pelvic anatomy. This tips and tricks video tutorial may be an important tool for improving surgical know-how, and thus for reducing the risk of ureteral injury. In particular, identification of the USLs and ureters, proper suture positioning and final cystoscopy are key points to minimize ureteral damage.
子宫骶韧带（USL）悬吊术是修复盆腔器官脱垂的一种有效且通用的外科技术。然而，输尿管损伤是一种令人担忧的并发症，可能会成为使用USL悬吊术的重大阻碍。该视频的目的是提供关键步骤，在成功进行经阴道USL悬吊术的同时将输尿管损伤风险降至最低。
该特色视频提供了一系列手术技巧，无论计划进行的手术是阴道子宫切除术、子宫切除术后阴道穹窿修复术还是子宫固定术，在进行USL悬吊术时都可用于保护输尿管。
这些技巧分为四类：子宫骶韧带的识别、输尿管的识别、缝线的穿过以及最终措施。
USL悬吊技术需要充分的外科培训以及对盆腔解剖结构的了解。这个技巧视频教程可能是提高手术技能的重要工具，从而降低输尿管损伤的风险。特别是，子宫骶韧带和输尿管的识别、正确的缝线定位以及最后的膀胱镜检查是将输尿管损伤降至最低的关键点。
