Kettel L M, Hebertson R M
Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.
Surg Gynecol Obstet. 1989 Apr;168(4):318-22.
A series of 31 sacrospinous ligament suspensions performed for correction of genital prolapse between 1980 and 1986 is reviewed. The success rate was 81 per cent. A cadaver dissection of the sacrospinous ligament was also performed with the same approach used at operation. This was done to understand better the relationships involved, to identify areas of potential complications and to improve the technique used. A dense fascia covers the coccygeus muscle, and care should be taken not to confuse this with the sacrospinous ligament. The possibility of injury to the nearby vessels and nerves can be avoided with the careful placement of suture through the sacrospinous ligament and two fingerbreadths medial to its insertion on the ischial spine. At the conclusion of the suspension, the vaginal apex should be intimately attached to the coccygeus muscle and sacrospinous ligament complex. The use of absorbable suture has been recommended by some, but the success of the procedure may be increased by using permanent suture. If anatomic relationships of the nearby structures are remembered, sacrospinous ligament suspension can be a safe, effective and relatively simple procedure for the correction of severe prolapse of the vaginal vault.
回顾了1980年至1986年间为纠正生殖器脱垂而进行的31例骶棘韧带悬吊术。成功率为81%。还采用手术时相同的方法对骶棘韧带进行了尸体解剖。这样做是为了更好地了解其中的关系，确定潜在并发症的部位，并改进所使用的技术。致密的筋膜覆盖着尾骨肌，应注意不要将其与骶棘韧带混淆。通过在骶棘韧带及其坐骨棘附着点内侧两指宽处小心放置缝线，可以避免损伤附近的血管和神经。悬吊结束时，阴道顶端应紧密附着于尾骨肌和骶棘韧带复合体。一些人推荐使用可吸收缝线，但使用永久性缝线可能会提高手术成功率。如果记住附近结构的解剖关系，骶棘韧带悬吊术对于纠正阴道穹窿严重脱垂可以是一种安全、有效且相对简单的手术。
