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Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy for the treatment of uterine prolapse.
Int Urogynecol J. 2016 Jan; 27(1):151-3.IU

Abstract

INTRODUCTION AND HYPOTHESIS

The objective is to describe our surgical approach for management of uterine prolapse using 5-mm skin incisions and transcervical morcellation.

METHODS

This video presents a novel approach for laparoscopic supracervical hysterectomy, bilateral salpingectomy, and sacrocervicopexy using only 5-mm skin incisions and transcervical morcellation. The procedure begins with a laparoscopic supracervical hysterectomy with bilateral salpingectomy. A classic intrafascial supracervical hysterectomy (CISH) instrument is then used transvaginally to core the endocervical canal. A disposable morcellator is placed through the remaining cervix to morcellate the uterus and fallopian tubes. Following morcellation, the handle of the morcellator is removed, and it is used during the remainder of the surgery as an access cannula for the sacrocervicopexy. The polypropylene mesh is introduced through this cannula. It is secured to the anterior and posterior vaginal fascia with a suture that is also introduced through the transcervical port. At the conclusion of the surgery, a previously placed 0 Vicryl purse-string suture at the ectocervix is tied down as a cerclage around the cervix once the cannula is removed.

CONCLUSIONS

The transcervical morcellation technique demonstrated in this video allows the surgeon to maintain 5-mm skin incisions and core the endocervical canal during a laparoscopic supracervical hysterectomy with sacrocervicopexy.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA. sdessie@mah.harvard.edu. Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA. sdessie@mah.harvard.edu. Department of Obstetrics and Gynecology, Mount Auburn Hospital, 725 Concord Ave, Suite 1200, Cambridge, MA, 02138, USA. sdessie@mah.harvard.edu.Department of Obstetrics and Gynecology, Newton-Wellesley Hospital, Newton, MA, USA.Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA. Department of Obstetrics and Gynecology, Mount Auburn Hospital, 725 Concord Ave, Suite 1200, Cambridge, MA, 02138, USA.

Pub Type(s)

Case Reports
Journal Article
Video-Audio Media

Language

eng

PubMed ID

25990208

Citation

Dessie, Sybil G., et al. "Laparoscopic Supracervical Hysterectomy With Transcervical Morcellation and Sacrocervicopexy for the Treatment of Uterine Prolapse." International Urogynecology Journal, vol. 27, no. 1, 2016, pp. 151-3.
Dessie SG, Park M, Rosenblatt PL. Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy for the treatment of uterine prolapse. Int Urogynecol J. 2016;27(1):151-3.
Dessie, S. G., Park, M., & Rosenblatt, P. L. (2016). Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy for the treatment of uterine prolapse. International Urogynecology Journal, 27(1), 151-3. https://doi.org/10.1007/s00192-015-2732-7
Dessie SG, Park M, Rosenblatt PL. Laparoscopic Supracervical Hysterectomy With Transcervical Morcellation and Sacrocervicopexy for the Treatment of Uterine Prolapse. Int Urogynecol J. 2016;27(1):151-3. PubMed PMID: 25990208.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy for the treatment of uterine prolapse. AU - Dessie,Sybil G, AU - Park,Michele, AU - Rosenblatt,Peter L, Y1 - 2015/05/20/ PY - 2015/03/06/received PY - 2015/04/23/accepted PY - 2015/5/21/entrez PY - 2015/5/21/pubmed PY - 2016/11/2/medline KW - Laparoscopy KW - Morcellation KW - Pelvic organ prolapse KW - Sacrocervicopexy SP - 151 EP - 3 JF - International urogynecology journal JO - Int Urogynecol J VL - 27 IS - 1 N2 - INTRODUCTION AND HYPOTHESIS: The objective is to describe our surgical approach for management of uterine prolapse using 5-mm skin incisions and transcervical morcellation. METHODS: This video presents a novel approach for laparoscopic supracervical hysterectomy, bilateral salpingectomy, and sacrocervicopexy using only 5-mm skin incisions and transcervical morcellation. The procedure begins with a laparoscopic supracervical hysterectomy with bilateral salpingectomy. A classic intrafascial supracervical hysterectomy (CISH) instrument is then used transvaginally to core the endocervical canal. A disposable morcellator is placed through the remaining cervix to morcellate the uterus and fallopian tubes. Following morcellation, the handle of the morcellator is removed, and it is used during the remainder of the surgery as an access cannula for the sacrocervicopexy. The polypropylene mesh is introduced through this cannula. It is secured to the anterior and posterior vaginal fascia with a suture that is also introduced through the transcervical port. At the conclusion of the surgery, a previously placed 0 Vicryl purse-string suture at the ectocervix is tied down as a cerclage around the cervix once the cannula is removed. CONCLUSIONS: The transcervical morcellation technique demonstrated in this video allows the surgeon to maintain 5-mm skin incisions and core the endocervical canal during a laparoscopic supracervical hysterectomy with sacrocervicopexy. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/25990208/Laparoscopic_supracervical_hysterectomy_with_transcervical_morcellation_and_sacrocervicopexy_for_the_treatment_of_uterine_prolapse_ DB - PRIME DP - Unbound Medicine ER -