TRT_SYSTEM-Procedure课程.pptVIP

* * * * * * * * TRT? REMEEX SYSTEM “ SURGICAL PROCEDURE” January 2008 PROCEDURE MATERIALS NEEDED FOR REMEEX ? IMPLANTATION: 1 REMEEX ? SYSTEM: (sling+varitensor+manipulator+disconnector) 2 PASSERS (must be previously sterilized) 1 HANDLE (must be previously sterilized) 1 CYSTOSCOPE TRT? SYSTEM– tension free readjustable tape PROCEDURE ABDOMINAL INCISION Small transversal incision (4 cm) at the abdominal line, just over the pubis. Fat dissection until the fascia of the abdominal rectal muscles is exposed. TRT? SYSTEM– tension free readjustable tape PROCEDURE VAGINAL INCISION Patient placed in lithotomy Position. Inverted U incision (2cm), at the anterior wall and make a good dissection of the area, leaving two paraurethral spaces. TRT? SYSTEM– tension free readjustable tape PROCEDURE INTRODUCTION OF THE TRACTION THREADS Pass the traction thread needle, lateral to the urethra, through the Retzius space. Feeling the posterior aspect of the pubis with the needle tip during its passage. Do not go too lateral to the pelvic side wall to avoid injury of the pelvic vessels and make sure to stay away from the abdominal cavity. TRT? SYSTEM– tension free readjustable tape PROCEDURE CYSTOSCOPY REVISION Endoscopic revision of the bladder integrity. If damaged, repeat the needle passage. TRT? SYSTEM– tension free readjustable tape PROCEDURE MESH PLACEMENT Place the sling at the mid urethra. The sling must be in FULL CONTACT with the submucosal tissue. Introduce the suture threads through the passer proximal holes. TRT? SYSTEM– tension free readjustable tape PROCEDURE SUTURE TRHEADS TRACTION Pull the tip of the passer from the abdominal incision and clamp the traction thread tips with a forceps. Close the vaginal incision. Now, a change of gloves is recommended. TRT? SYSTEM– tension free readjustable tape PROCEDURE VARITENSOR PLACEMENT Insert the traction suture threads through the Varitensor’s respective