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无网片之扰;阴道自然腔道内镜手术(vNOTES)用于阴道压力性尿失禁手术的自体腹直肌后筋膜网片。

No mess with mesh; vaginal natural orifice transluminal endoscopic surgery (vNOTES) autologous posterior rectus fascia mesh for vaginal urinary incontinence procedures.

机构信息

Department of Obstetrics and Gynecology, Imelda Hospital, Bonheiden, Belgium; Department of Development and Regeneration, Faculty of Medicine, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.

Department of Obstetrics and Gynecology, Imelda Hospital, Bonheiden, Belgium.

出版信息

J Gynecol Obstet Hum Reprod. 2024 Oct;53(8):102816. doi: 10.1016/j.jogoh.2024.102816. Epub 2024 Jun 21.

Abstract

Urinary incontinence affects 25-45 % of women with the gold standard surgical approach being placement of mid-urethral synthetic slings; tension-free vaginal tape (TVT) and trans-obturator tape (TOT). Due to the controversies regarding vaginal mesh the last decade, an increasing demand has evolved for incontinence treatment without vaginal synthetic mesh. The short term results of autologous rectus fascia sling for TOT surgery have shown similar success rates compared to those after the use of synthetic mesh, but the harvesting of the mesh is less minimally invasive and is associated with longer surgical time. vNOTES is a combination of a vaginal entrance to the abdomen and endoscopy via the vagina. The aim with the video is to show a new surgical technique with a fully vaginal, scarless vNOTES approach for harvesting the posterior rectus fascia for TVT and TOT procedures.

摘要

尿失禁影响 25-45%的女性,金标准的手术方法是放置中尿道合成吊带;无张力阴道吊带(TVT)和经闭孔吊带(TOT)。由于过去十年阴道网片存在争议,因此对无阴道合成网片的尿失禁治疗的需求不断增加。用于 TOT 手术的自体腹直肌筋膜吊带的短期结果显示与使用合成网片后的成功率相似,但网片的采集微创性较差,且与较长的手术时间相关。vNOTES 是阴道进入腹部和阴道内镜的组合。该视频的目的是展示一种新的手术技术,即完全阴道、无疤痕的 vNOTES 方法,用于采集 TVT 和 TOT 手术的后腹直肌筋膜。

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