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Lap Ileal Ureter Following Extensive Ureteric Stricture
Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S228–S229 portion of the mesh. This is repeated posteriorly. This technique allows the secure attachment of the mesh to the full vaginal length. 758 Minilaparoscopic Repair of a Vesicovaginal Fistula Mattingly P, Taylor B. Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina This video demonstrates a minilaparoscopic repair of a vesicovaginal fistula, using 3mm laparoscopic instruments. A 38 year old multigravida with a history of cervical incompetence underwent a transvaginal cerclage without any recognized complications. However, she presented with urinary incontinence later in that pregnancy and diagnosed with a vesicovaginal fistula. When vaginal repair is not feasible, vesicovaginal fistulas have traditionally been repaired by laparotomy. However, literature shows that laparoscopic repair is a safe and feasible alternative. The purpose of this video is to demonstrate a technique for a minilaparoscopic repair of a vesicovaginal fistula, using 3mm laparoscopic instruments. 760 Chronic Pelvic Pain & Stress Urinary Incontinence Resolution after Laparoscopic TVT Removal & Burch/ Paravaginal Repair Miklos JR, Moore RD, Chinthakanan O. International Urogynecology Associates, Alpharetta, Georgia The purpose of this video: 1) Discuss the surgical treatment of pain complications associated with TVT type retropubic slings 2) demonstrate our laparoscopic approach to complete TVT removal 3) demonstrate
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simultaneous laparoscopic Burch and paravaginal repair for stress urinary incontinence (SUI) and a cystocele. A patient presented with dyspareunia, vaginal, lower abdominal & pubic pain since the placement of her TVT. Physical examination confirms paraurethral pain, stress urine incontinence and a cystocele. The patient requested sling removal due to the severity of the pain and its affect on her quality of life. A transvaginal dissection coupled with a laparoscopic approach was utilized to completely excise the sling from the vagina to the anterior abdominal wall. A simultaneous Burch and paravaginal repair were performed for her SUI and cystocele. Post operatively she had complete resolution of her pain, SUI and cystocele. 761 Lap Ileal Ureter Following Extensive Ureteric Stricture Telang MP, Puntambekar GS, Joshi S, Lawande A, Puntambekar SP. Galaxy Care Laparoscopy Institute, Pune, Maharashtra, India Ileal-ureteral substitution is a viable surgical procedure to provide a satisfactory solution to the problem of long segment ureteric defect. Laparoscopic harvesting of a segment of the ileum as a substitute for the ureter, followed by ureteroileal and ileo-vesical anastomosis with pure intracorporeal laparoscopic suturing was performed in a 45yr old female with mid and lower ureteric stricture following laparoscopic radical hysterectomy and postoperative radiotherapy for carcinoma cervix. Using transperitoneal five port technique we removed the strictured ureter and created an ileal ureter. Ileo-ureteric, ileo-vesical and ileo-ileal anastomosis was done completely by intracorporeal technique. Urinary drainage was satisfactory and renal function were improved. She did not complain of or had symptoms of urinary-tract infection or metabolic acidosis. The results of the present case is encouraging; other clinical studies with more patients are needed to determine exact role of totally intracorporeal laparoscopic ileal interposition to repair the extensive ureteric stricture.
S229
simultaneous laparoscopic Burch and paravaginal repair for stress urinary incontinence (SUI) and a cystocele. A patient presented with dyspareunia, vaginal, lower abdominal & pubic pain since the placement of her TVT. Physical examination confirms paraurethral pain, stress urine incontinence and a cystocele. The patient requested sling removal due to the severity of the pain and its affect on her quality of life. A transvaginal dissection coupled with a laparoscopic approach was utilized to completely excise the sling from the vagina to the anterior abdominal wall. A simultaneous Burch and paravaginal repair were performed for her SUI and cystocele. Post operatively she had complete resolution of her pain, SUI and cystocele. 761 Lap Ileal Ureter Following Extensive Ureteric Stricture Telang MP, Puntambekar GS, Joshi S, Lawande A, Puntambekar SP. Galaxy Care Laparoscopy Institute, Pune, Maharashtra, India Ileal-ureteral substitution is a viable surgical procedure to provide a satisfactory solution to the problem of long segment ureteric defect. Laparoscopic harvesting of a segment of the ileum as a substitute for the ureter, followed by ureteroileal and ileo-vesical anastomosis with pure intracorporeal laparoscopic suturing was performed in a 45yr old female with mid and lower ureteric stricture following laparoscopic radical hysterectomy and postoperative radiotherapy for carcinoma cervix. Using transperitoneal five port technique we removed the strictured ureter and created an ileal ureter. Ileo-ureteric, ileo-vesical and ileo-ileal anastomosis was done completely by intracorporeal technique. Urinary drainage was satisfactory and renal function were improved. She did not complain of or had symptoms of urinary-tract infection or metabolic acidosis. The results of the present case is encouraging; other clinical studies with more patients are needed to determine exact role of totally intracorporeal laparoscopic ileal interposition to repair the extensive ureteric stricture.