To describe a technique for performing laparoscopic Burch colposuspension using a 3-trocar system.
This educational video provides step-by-step instructions for performing a laparoscopic Burch colposuspension.
Midurethral slings are an effective surgical treatment for women with stress urinary incontinence, but not all patients are candidates for, or desire, vaginal mesh. For stress incontinence, non-mesh surgical procedures include pubovaginal fascial slings and retropubic Burch colposuspenion. Colposuspension may be performed via an open or laparoscopic approach. As with other minimally invasive surgeries, laparoscopic colposuspension has decreased blood loss, pain, and length of stay with equivalent outcomes at 2 years compared to open procedure. This video describes a technique for performing laparoscopic Burch colposuspension using a 3-trocar system.
A laparoscopic Burch colposuspension is described using a 3-trocar system. Detailed step-by- step instructions are given, along with visualization of pertinent anatomy. Supplies needed for this procedure include: a zero-degree 5 mm laparoscope, two 5 mm trocars - one to be placed in the umbilicus and one in the left lower quadrant, one 5/12 mm trocar to be placed in the right lower quadrant for passing needles, a closed knot pusher, laparoscopic scissors, and two needle drivers. This technique assumes that the primary surgeon (located on the patient's left) is right-handed, and that both surgeons can suture and tie knots laparoscopically. Tips are highlighted to ensure safety and ensure successful completion of the procedure.
Laparoscopic Burch colposuspension offers a non-mesh based repair for women with stress urinary incontinence using a minimally invasive approach. It is a reasonable alternative to offer patients with stress urinary incontinence who do not desire repair using vaginal mesh.
Journal of minimally invasive gynecology. 2016 Aug 20 [Epub ahead of print]
Audra Jolyn Hill, Karl Jallad, Mark D Walters
Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics/Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: ., Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics/Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.