7. il 30% delle donne sottoposte a chirurgia fasciale và incontro a recidiva , che costringe al reintervento, entro 4 anni
8.
9. progressi di biotecnologia e di materiali protesici che promuovono la crescita di tessuto connettivo di supporto chirurgia protesica miniinvasiva Nuova concezione chirurgica nei difetti del pavimento pelvico
10. IVS Intra Vaginal Slingplasty Pelvic Floor Center, Montecchio Emilia
15. Surgical technique: the Perigee device Insertion of the Perigee upper needles Insertion of the Perigee lower needles Final position of the Perigee mesh
17. International Consultation for incontinence Committee for pelvic organ prolapse review Non vi sono dati sufficienti per poter tirare conclusioni definitive sul ruolo dei materiali protesici in chirurgia ricostruttiva pelvica ICI Parigi 2008
18.
19. compartimento anteriore Maher C; Baessler K. Int Urogyn J 2006 uso delle reti compartimento posteriore meno convincente più convincente riparazione fasciale tasso di successo: 80-85%
This illustration in the dorsal lithotomy position demonstrates a total implant in its final position. Anteriorly, the mesh is placed in the vesicovaginal space, with the superficial and deep straps traversing through the obturator foramen. Posteriorly, the mesh is in the rectovaginal space, overlying the rectal muscularis and the straps traversing the sacrospinous ligaments. The mesh is placed from the middle third of the vagina to both sidewalls, and then, back to the uterosacral ligaments at the level of the ischial spines. Now that you have seen the total implant in its final position, let me explain the steps of how to get it there. In order to get an implant into position, a thorough vaginal dissection needs to be made and paths for the straps need to be made. First I am going to describe the anterior path for placing the superficial and deep straps and then I will describe the posterior path. During an anterior, posterior, or total repair using the GYNECARE PROLIFT * Pelvic Floor Repair System, t he patient should be placed in the lithotomy position with her buttocks slightly overlapping the table and her thighs flexed at approximately 90 degrees in relation to the plane of the table. If the surgeon is performing an anterior or total repair, he/she can determine the limits of the obturator foramen by placing the index finger in the vagina and palpating with the thumb externally where the obturator membrane comes into contact with the bony boundaries. Note: Retrospective data analysis suggests that the rate of mesh exposure may be higher when performing the TVM procedure with concurrent hysterectomy.
About the design features of Pinnacel Blue mid line
Blunt dissection medial to ischial spine will identify and expose sacrospinous ligament; Proximal portion of arcus tendineous fascia pelvis (ATFP) will be identified anterolaterally. Ensure that the SSL is clear of any fibrous or fatty tissue.
Place apical sacrospinous Capio arm (leaving the Capio medial to the suture. This is done with the operator ipsilateral index finger). Make sure you are over the ligament and clear of any fibrous tissue over the ischial spine.
Identifying where Apogee is placed in relation to Elevate and as well as the pudendal verve
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