SACROCOLPOPEXY AT RAMAYYAS PRAMILA HOSPITALS: SURGERY FOR VAULT PROLAPSE

A 60 year old lady presented with vault prolapse after vaginal hysterectomy.The patient was taken up for sacrocolpopexy ( open Pfannenstiel incision).

The procedure:

The vagina is first freed from the bladder at the front and the rectum at the back. A graft made of permanent synthetic mesh is used to cover the front and the back surfaces of the vagina. The mesh is then attached to the sacrum  as shown in the illustration. The mesh is then covered by a layer of tissue called the peritoneum that lines the abdominal cavity; this prevents the bowel from getting stuck to the mesh. 

T SHAPED SLING MADE UP FROM PROLENE MESH 

DISSECTION OF THE VAULT AFTER PUSHING BLADDER AND RECTUM AWAY 

THE TWO LIMBS OF THE "T" MESH ATTACHED AND ANCHORED TO ANTERIOR AND POSTERIOR VAGINAL WALLS