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OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE Dr. Pradeep  Garg Assistant Professor Obstetrics & Gynaecology, All India Institute of Medical Sciences New Delhi-110029
Incidence ,[object Object],[object Object]
Etiology ,[object Object],[object Object],[object Object]
Operations for nulliparous prolapse ,[object Object],[object Object],[object Object],[object Object]
Aim/Advantages of conservative surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conservative surgery ,[object Object],[object Object],[object Object],[object Object]
Abdominal Sling operations ,[object Object],[object Object],[object Object],[object Object],[object Object]
Abdominal Sling operations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Shirodkar’s sling ,[object Object],[object Object]
Shirodkar’s sling ,[object Object],[object Object]
SHIRODKAR’S SLING OPERATION (1960)
Purandare’s cervicopexy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PURANDARE’s CERVICOPEXY (1965)
Khanna’s sling operation ,[object Object],[object Object]
Khanna’s Posterior sling operation (1972)
Joshi’s Sling ,[object Object]
Joshi’s Sling 1993
Virkud’s composite sling operation ,[object Object],[object Object]
Virkud’s Sling ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Virkud’s Sling 1999 S P S C
Soonawala’s Sling  ,[object Object]
Soonawala’s Sling
Ureter Video To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Sacrocervicopexy Video To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Sacrocervicopexy Video ,[object Object],To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Sacrocervicopexy ,[object Object],[object Object],[object Object],[object Object]
Nulliparous Prolapse Shirodker’s + Khanna’s  Cervicopexy Video To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Laparoscopic Cervicopexy/sling Operations ,[object Object],[object Object],[object Object]
Laparoscopic surgery  prolapse ,[object Object],[object Object]
[object Object]
Vaginal vault prolapse ,[object Object]
Incidence ,[object Object],[object Object]
Etiology ,[object Object],Fig-1 Fig-2
Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management Prolifit and Apogee Mesh Sacrocolpopexy Uterosacral suspension Sacrospinous fixation Paravaginal repair Laparoscopic Posterior intravaginal singplasty Tape Zacharin’s procedure Abdominoperineal Abd Uterosacral suspension Sacrocolpopexy Rectus sheath colpopexy Abdominal Sacrospinous/iliococcygeous fixation Uterosacral suspension Le fort operation Colpocliesis/colpectomy/vaginectomy Vaginal
Laparoscopic sacrocolpopexy
Mesh ,[object Object],[object Object],[object Object],[object Object]
Final position of the Mesh in Pelvis
Final position of the Mesh in Pelvis (Side view) Video
Advantages of Laparoscopic approach  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of Laparoscopic Approach ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications of Laparoscopic Approach…
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications of Laparoscopic Approach…
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications of Laparoscopic Approach…
Vascular pelvic anatomy Video To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Are laparoscopic procedure recommended ?  ,[object Object],[object Object],[object Object]
Sacrospinous Ligament Suspension   ,[object Object]
Vaginal Sacrospinous fixation Video To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Abdominal sacrocolpopexy Vs Sacrospinous fixation ,[object Object]
Unilateral Vs bilateral  Sacrospinous fixation  ,[object Object]
Abdominal sacrocolpopexy Vs Sacrospinous fixation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic uterosacral suspension Video To see videos on laparoscopic gynae surgeries  please logon to   www .youtube.com   and type Pradeep aiims
Iliococcygeal vaginal suspension ,[object Object]
Iliococcygeus fixation  ,[object Object]
Vault suspention to ant abd wall ,[object Object],[object Object],[object Object],[object Object],[object Object]
Colpocleisis ,[object Object]
Time has come for Laparoscopic Surgery for Prolapse So move with the times.  Practice laparoscopy. This is the Surgery of the future today.
Prevention of vault prolapse at the time of  hysterectomy ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Thank You

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Operations For Nulliparous Prolapse And Vaginal Vault Prolapse, Mob: 7289915430, www.drpradeepgarg.com,