V2-08 ROBOTIC-ASSISTED LAPAROSCOPIC REMOVAL OF EXTRUDED SACROCOLPOPEXY MESH

Abstract

You have accessJournal of UrologyFemale Voiding Dysfunction1 Apr 2015V2-08 ROBOTIC-ASSISTED LAPAROSCOPIC REMOVAL OF EXTRUDED SACROCOLPOPEXY MESH Kai-wen Chuang, Christopher Hartman, Akin Carons, Manaf Alom, Paras Shah, Lee Richstone, and Farzeen Firoozi Kai-wen ChuangKai-wen Chuang More articles by this author , Christopher HartmanChristopher Hartman More articles by this author , Akin CaronsAkin Carons More articles by this author , Manaf AlomManaf Alom More articles by this author , Paras ShahParas Shah More articles by this author , Lee RichstoneLee Richstone More articles by this author , and Farzeen FirooziFarzeen Firoozi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.333AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Mesh sacrocolpopexy is an effective treatment strategy for both high grade and refractory pelvic organ prolapse. Graft erosion into the vagina, bladder or urethra, however, is a recognized complication of nonabsorbable mesh and can result in significant morbidity. The management of an eroded sacrocolpopexy mesh can be technically challenging and traditionally requires an abdominal laparotomy which carries its own perioperative morbidity. We demonstrate a minimally invasive robotic approach to removing the sacrocolpopexy mesh extruding in the vagina. METHODS Vaginal exam demonstrated the extruded mesh at the apex of the vagina. With the patient in Trendenlenberg position and employing robotic assistance, the pelvis was thoroughly examined. The Sigmoid colon was identified, mobilized and reflected laterally, hence exposing the sacral promontory. A fibrous band enveloping the mesh was identified from the sacral promontory to the apex of the vagina. The mesh was dissected and excised in its entirety. A vaginotomy was performed to access the vagina portion of the mesh and this was excised. The vaginal defect was closed in two layers and a foley catheter was placed. RESULTS Duration of procedure was 150 minutes. Estimated blood loss was 10cc. Vaginal packing and foley catheter were placed postoperatively and removed on postoperative day 1. Currently, the patient reports resolution of her lower back pain and vaginal discharge as well as improvement in dyspareunia symptoms. CONCLUSIONS Transabdominal robotic-assisted laparoscopic removal of sacrocolpopexy mesh is an effective, safe, and less morbid alternative to the traditional open approach for the management of mesh extrusion. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e100 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kai-wen Chuang More articles by this author Christopher Hartman More articles by this author Akin Carons More articles by this author Manaf Alom More articles by this author Paras Shah More articles by this author Lee Richstone More articles by this author Farzeen Firoozi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...