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Master Class in Gynecologic Surgery: A New Anterior Repair (Featuring Dr. Robert Kovac)

In this cooperative effort, Ob. Gyn. News and AAGL SurgeryU will be working very closely together to promote education in minimally invasive gynecologic surgery. This collaboration will allow viewers the opportunity to examine state-of-the-art procedures from true experts in our field. Not only will these videos be accompanied with a summary abstract, but the complete article pertaining to the surgery can be view via a link to Ob. Gyn. News. Again, thank you for your interest and please enjoy this exciting new venture.

Bladder prolapse is the result of a transverse defect that separates the pubocervical fascia from the pericervical ring. The proper surgical approach to true cystocele, therefore, requires a transverse defect repair. Once the vesicovaginal space has been exposed, the trapezoidal-shaped pubocervical fascia is dissected from the underside of the vaginal epithelium without splitting the vagina. Superior elevation of the detached pubocervical fascia exposes the herniated bladder.  Sutures placed into the prespinous fascia inferior to the ischial spine–as well as sutures placed through or around the retroperitoneal uterosacral ligament– are then passed through the lateral sides of a precut piece of biologic graft material. The defect is repaired with sutures through the graft, pubocervical fascia, and then the pericervical ring. The lateral sutures are then tied, beginning with the prespinous sutures, and the top of the graft is transfixed with sutures to the pubocervical fascia.

The Ob. Gyn News’ Master Class in Gynecologic Surgery is hosted by AAGL SurgeryU, and is edited by Dr. Charles E. Miller, a past president of the AAGL, and a long standing faculty member of SurgeryU.

Filed under "Master Course in Gynecologic Surgery".

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