Objective To summarize the therapeutic experiences of abdominal wall bulge repair with compound patch intraperitoneal placement. Methods From October 2005 to October 2008, intraperitoneal onlay mesh with compound patch applied in 7 patients with abdominal wall bulge, whose clinical data were analyzed retrospectively. Results All the procedures were performed successfully, including 5 open operation and 2 laparoscopic repair. The mean operation time was 85 min (ranged 68 to 130 min). After operation, 1 seroma formation and 1 hemorrhage in the thoracic cavity developed and were cured with the conservative therapy. Mean postoperative hospital stay was 9.5 d (ranged 8 to 16 d). There was no recurrence, infection, or prolonged pain during 1－4 years follow-up. Conclusion Abdominal wall bulge is caused by the weakness of abdominal wall muscle, and the intraperitoneal onlay mesh repair with compound patch is an appropriate therapy.
ObjectiveTo evaluate the feasibility and efficacy of laparoscopic paravaginal repair (LPVR) for anterior vaginal prolapse in women of child-bearing age. MethodsTotally, 21 patients with anterior vaginal prolapse underwent laparoscopic extraperitoneal vaginal vault suspension between January 2012 and May 2013. Among the 21 patients, 5 were in grade Ⅲ, 15 in grade Ⅱ, and 1 in grade Ⅰ. Under laparoscope, the bilateral white lines and ischial spines were exposed, and then the angle of vaginal fornix was sutured to the ipsilateral ischial spine and the vaginal wall was sutured to the ipsilateral white line. Laparoscopic sacrocolpopexy or Burch or posterior vaginal wall repair was performed as well if necessary. The patients without any subjective symptom were defined as subjective cure and those whose pelvic organ prolapse quantification of anterior vaginal was zero degree were defined as objective cure. ResultsLaparoscopic sacrocolpopexy was performed in 5 patients, Burch in 3, and posterior vaginal wall repair alone in 6. The operation time ranged from 110 to 225 minutes with an average of 155 minutes, and the intraoperative blood loss ranged from 30 to 100 mL with an average of 60 mL. No intraoperative complication occurred. The marking point of pelvic organ prolapse quantitation Aa before and after operation was (1.0±0.4) cm and (-3.0±0.8) cm, and Ba was (1.5±0.4) cm and (-3.0±0.5) cm, and there were significant differences (P<0.01). The patients were discharged from hospital within 5 to 10 days averaging 7 days. The cost of hospitalization was 7 000 to 11 000 yuan, with an average of 8 500 yuan. One patient who felt obstruction of urethra and diffcult urination was improved by keeping indwelling urinary catheter for 7 days. Follow-up was achieved in 21 patients for 10 to 18 months with a mean of 15 months, and 19 of them had subjective cure and 20 of them objective cure. ConclusionLPVR can be successfully completed in anterior vaginal prolapse patients with paravaginal defect with less injury and shorter recovery time.