Modified Le Fort Partial Colpocleisis with Levator Plication and Perineorrhpahy

Abstract

The purpose of this video is to demonstrate the Modified Le Fort Colpocleisis procedure. Our modification involves the excision of a triangular tissue flap, rather than the traditionally described rectangular flap. This shape allows the lateral vaginal tunnels to flare-out at the introitus, which minimizes the incidence of pyocolpos. Additionally, this allows us to incorporate the distal 2 cm of the posterior vaginal mucosa into the vertical closure of the perineoplasty. The effect of this modification is the creation of an invaginated introitus, rather than a “flat” pelvic plate. This prevents the closure from placing traction on the bladder, which contributes to post-procedure incontinence. It also provides a more cosmetically “normal” appearance.