Below we describe the laparoscopic modification by Trifyllis of the classic vaginal uterosacral ligament suspension.
Obliteration of the pouch of Douglas.
Ureteral injury or kinking and consequent hydronephrosis between 1.8% and 10.9% in international bibliography concerning the vaginal route. We estimate that this rate can be significantly lower with this laparoscopic technique.
Nephrosonography for possible hydronephrosis. In case of hydronephrosis the ipsilateral suture has to be extracted.
Aydin, C, Mercimek, MN. Laparoscopic management of bladder injury during total laparoscopic hysterectomy. Int J Clin Pract. 2020; 00:e13507. https://doi.org/10.1111/ijcp.13507
Manodoro, S., Frigerio, M., Milani, R. et al. Tips and tricks for uterosacral ligament suspension: how to avoid ureteral injury. Int Urogynecol J29, 161–163 (2018). https://doi.org/10.1007/s00192-017-3497-y
Panico, G., Campagna, G., Caramazza, D. et al. Laparoscopic high uterosacral ligament suspension: an alternative route for a traditional technique. Int Urogynecol J29, 1227–1229 (2018). https://doi.org/10.1007/s00192-018-3588-4
Siff, Lauren N. MD; Jallad, Karl MD; Hickman, Lisa C. MD; Walters, Mark D. MD Surgical Anatomy of the Uterosacral Ligament Colpopexy, Female Pelvic Medicine & Reconstructive Surgery: September/October 2018 – Volume 24 – Issue 5 – p 380-382 doi: 10.1097/SPV.0000000000000461