Your browser doesn't support javascript.
loading
More With Less: Single-Incision Sling Insertion Techniques.
Wheat, Joy E; Welch, Eva K; Heuer, Christopher W; Dengler, Katherine L; Gruber, Daniel D; von Pechmann, Walter S.
Afiliación
  • Wheat JE; Walter Reed National Military Medical Center, Bethesda, MD (Drs. Wheat, Welch, Heuer, and Dengler); Brooke Army Medical Center, Fort Sam Houston, TX (Drs. Wheat and Welch).. Electronic address: joyw80@gmail.com.
  • Welch EK; Walter Reed National Military Medical Center, Bethesda, MD (Drs. Wheat, Welch, Heuer, and Dengler); Brooke Army Medical Center, Fort Sam Houston, TX (Drs. Wheat and Welch).
  • Heuer CW; Walter Reed National Military Medical Center, Bethesda, MD (Drs. Wheat, Welch, Heuer, and Dengler).
  • Dengler KL; Walter Reed National Military Medical Center, Bethesda, MD (Drs. Wheat, Welch, Heuer, and Dengler).
  • Gruber DD; John Hopkins Medicine-Sibley Memorial Hospital, Washington, DC (Dr. Gruber).
  • von Pechmann WS; Inova Fairfax Hospital, Falls Church, VA (Dr. von Pechmann).
J Minim Invasive Gynecol ; 31(5): 364, 2024 May.
Article en En | MEDLINE | ID: mdl-38307223
ABSTRACT
STUDY

OBJECTIVE:

To demonstrate reproducible procedures for efficient single-incision sling insertion and troubleshooting.

DESIGN:

Narrated video footage with stepwise demonstration of single-incision sling insertion technique with anchor system.

SETTING:

The mesh midurethral sling is a highly effective and safe procedure that is considered the gold standard for surgical treatment of stress urinary incontinence. Retropubic and transobturator approaches for midurethral slings have similar subjective cure rates with differing surgical risk profiles [1,2]. The retropubic route has a higher risk of injury to the bladder, nerves, and vascular structures, whereas the obturator approach carries a risk of groin or thigh pain [3-5]. Use of a single-incision sling decreases these risks and allows flexibility to perform the procedure without sedation or general anesthesia. Recent literature demonstrates similar subjective and objective success and safety of single-incision slings compared with both retropubic and transobturator approaches, although long-term data are forthcoming [5].

INTERVENTIONS:

We demonstrate a stepwise approach for the insertion of a single-incision sling using a helical trocar. Easily reproducible procedures for setup and sling anchor management allow for efficient placement without assistance. In addition, we outline hand positioning, trocar management, and anchor deployment with troubleshooting techniques for potential placement difficulties. Finally, we review methods for sling tensioning to prevent complications such as voiding dysfunction and mesh or suture exposures.

CONCLUSION:

Given that single-incision slings are more likely to be performed under local anesthesia and are less invasive with decreased recovery time, it has the potential to become the preferred approach in the future. This video demonstrates clear and detailed steps to facilitate successful placement of the single-incision mesh midurethral sling.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Incontinencia Urinaria de Esfuerzo / Cabestrillo Suburetral Límite: Female / Humans Idioma: En Revista: J Minim Invasive Gynecol Asunto de la revista: GINECOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Incontinencia Urinaria de Esfuerzo / Cabestrillo Suburetral Límite: Female / Humans Idioma: En Revista: J Minim Invasive Gynecol Asunto de la revista: GINECOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos