Summary:
The Burch procedure has enjoyed in the last decade a favourable status among open surgical
repairs for stress urinary incontinence. In the last few years this technique was adapted for
endoscopic aplication. This results in decreased recovery time and diminished postoperative
patients discomfort. This endoscopic procedure was further simplified by means of extraperitone-
al approach and through the use of Mesh & Tacker technique. This enables a high quality durable
colposuspension in significantly shortened operational time.
Objective: Evaluation of preliminary results and experiences of the abovementioned new laparos-
copic extraperitoneal approach in the treatment of stress incontinence.
Setting: Department of Gynaecology and minimally invasive surgery Na Homolce Hospital.
Design: Prospective pilot study.
Methods: The patients with stress incontinence proven clinically and by means of urodynamic
investigation (cystometry, stress profilometry and uroflowmetry) were included in the study. The
Retzius space was dissected laparoscopically via preperitoneal distention balloon (PDB, Origin
Medsystems). Colpofixation to Coopers ligaments was achieved by means of Mesh & Tacker tech-
nique, e.g. polypropylen Mesh and aplicator of helicose spirals (Origin Medsystems).
Results: In this pilot study of initial 8 patients we may conclude that the abovementioned method
is promising. Of note is shortened operational time (35 min), easy performance without necessity
of laparoscopic endosuturing and minimal tissue damage. The small amount of patients and short
follow up period would not allow definite conclusions but all the patients are sofar fully conti-
nent.
Key words:
stress incontinence, Burch, laparoscopy, preperitoneal and transperitoneal approach,
Mesh & Tacker
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