Urinary incontinence affects 25-45% of women with the gold standard surgical approach being placement of mid-urethral synthetic slings; tension-free vaginal tape (TVT) and trans-obturator tape (TOT). Due to the controversies regarding vaginal mesh the last decade, an increasing demand has evolved for incontinence treatment without vaginal synthetic mesh. The short term results of autologous rectus fascia sling for TOT surgery have shown similar success rates compared to those after the use of synthetic mesh, but the harvesting of the mesh is less minimally invasive and is associated with longer surgical time. vNOTES is a combination of a vaginal entrance to the abdomen and endoscopy via the vagina. The aim with the video is to show a new surgical technique with a fully vaginal, scarless vNOTES approach for harvesting the posterior rectus fascia for TVT and TOT procedures.
Journal of gynecology obstetrics and human reproduction. 2024 Jun 21 [Epub ahead of print]
Jan Baekelandt, Ann Sofie Vertongen, Luka Matak, Andrea Stuart
Department of Obstetrics and Gynecology, Imelda Hospital, Bonheiden, Belgium; Department of Development and Regeneration, Faculty of Medicine, Group Biomedical Sciences, KU Leuven, Leuven, Belgium., Department of Obstetrics and Gynecology, Imelda Hospital, Bonheiden, Belgium., Department of Obstetrics and Gynecology, General Hospital Zadar, Croatia., Department of Obstetrics and Gynecology, Helsingborg, Sweden; Institution of Clinical Sciences, Dept. of Obstetrics and Gynecology, Lund University, Lund. Electronic address: .