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PelvicOrganReconstructive Surgery With compliments Andri Nieuwoudt Applying the Flagpole Concept in POR surgery
Requirements of the vaginal support system Anterior Wall: Mobility   Posterior Wall:  mobility Top: Stability
 
Requirements of the vaginal support system Anterior Wall: Mobility   Posterior Wall:  mobility Top: Stability = Temporary ...
Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole The flag
Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole The flag
Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole
Requirements of the vaginal support system Anterior Wall: Mobility   Posterior Wall:  mobility Top: Stability = Temporary ...
The Damage to the Rectovaginal septum The breaking of the POLE
 
With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com
rugae With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com Photo`s and slide by dr Richard Reid Recto-ent...
 
 
Repairing the Posterior compartment
 
With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com Photo`s and slide by de Richard Reid Recto-enterocel...
 
 
Sacro-spinous lig Sacro-spinous lig
 
Requirements the vaginal support system Anterior Wall: Mobility   Posterior Wall:  mobility Top: Stability = Temporary Sca...
With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com
Repairing the anterior compartment
1.Enter superficial Anterior Vaginal wall cleavage plain 1.Insnijding in de natuurlijke spatie in de vaginale voorwand Wit...
 
Blaaskatheter Catheter Vaginal wall Bladderwall With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
2. Penetrate attenuated lateral septum 2. Doodringen van zijwand scheiding tussen voorwand en zijde van bekken. With compl...
bladder vagina Paravaginal disection
With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
Cauterization of veins With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
3. Sweep Bladder (& Ureter) medially 3. Stroop blaas en urineleider na binnen ( weg van de bekkenzijwand) With compliments...
With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
4.  Place 4 pairs of stay sutures in Whiteline or Obturator membrane 4. 4 hechtingen paren worden door whiteline  of binne...
 
Cervix Symphysis Whiteline Sutures baarmoederhals schaambeen With compliments by Dr Andri Nieuwoudt www.pelvicorganreconst...
With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
5. Reconstruct “ trampoline” with SIS from whiteline to whiteline from Symphysis to cervix 5. Reconstructie van kapotte on...
bladder vagina
With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
Symphysis pubis Cervix schaambeen baarmoederhals With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
Break PelvicOrgan supports up into different “organs” The Flagpole concept Baie dankie vir u aandag With compliments dr An...
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PelvicOrganReconstructive Surgery

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PelvicOrganReconstructive Surgery

  1. 1. PelvicOrganReconstructive Surgery With compliments Andri Nieuwoudt Applying the Flagpole Concept in POR surgery
  2. 2. Requirements of the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability
  3. 4. Requirements of the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability = Temporary Scaffold = Semi-permanent Scaffold = Permanent solid support flag pole
  4. 5. Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole The flag
  5. 6. Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole The flag
  6. 7. Break PelvicOrgan supports up into different “organs” The Flagpole concept The pole
  7. 8. Requirements of the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability = Temporary Scaffold = Semi-permanent Scaffold = Permanent solid support flag pole biomesh Synthetic mesh
  8. 9. The Damage to the Rectovaginal septum The breaking of the POLE
  9. 11. With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  10. 12. rugae With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com Photo`s and slide by dr Richard Reid Recto-enterocele Linear EPF tear Enterocele defined Enterocele sac
  11. 15. Repairing the Posterior compartment
  12. 17. With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com Photo`s and slide by de Richard Reid Recto-enterocele Linear EPF tear Enterocele defined Enterocele sac
  13. 20. Sacro-spinous lig Sacro-spinous lig
  14. 22. Requirements the vaginal support system Anterior Wall: Mobility Posterior Wall: mobility Top: Stability = Temporary Scaffold = Semipermanent Scaffold = Permanent solid support flag pole Biomesh (SIS) Synthetic mesh
  15. 23. With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  16. 24. Repairing the anterior compartment
  17. 25. 1.Enter superficial Anterior Vaginal wall cleavage plain 1.Insnijding in de natuurlijke spatie in de vaginale voorwand With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  18. 27. Blaaskatheter Catheter Vaginal wall Bladderwall With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  19. 28. 2. Penetrate attenuated lateral septum 2. Doodringen van zijwand scheiding tussen voorwand en zijde van bekken. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  20. 29. bladder vagina Paravaginal disection
  21. 30. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  22. 31. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  23. 32. Cauterization of veins With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  24. 33. 3. Sweep Bladder (& Ureter) medially 3. Stroop blaas en urineleider na binnen ( weg van de bekkenzijwand) With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  25. 34. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  26. 35. 4. Place 4 pairs of stay sutures in Whiteline or Obturator membrane 4. 4 hechtingen paren worden door whiteline of binnen membraan van bekkenwand geplaatst With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  27. 37. Cervix Symphysis Whiteline Sutures baarmoederhals schaambeen With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  28. 38. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  29. 39. 5. Reconstruct “ trampoline” with SIS from whiteline to whiteline from Symphysis to cervix 5. Reconstructie van kapotte ondersteuning van de blaas met SIS van whiteline tot whiteline (zijwanden) van schaambeen tot baarmoederhals. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  30. 40. bladder vagina
  31. 41. With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  32. 42. Symphysis pubis Cervix schaambeen baarmoederhals With compliments by Dr Andri Nieuwoudt www.pelvicorganreconstruction.com
  33. 43. Break PelvicOrgan supports up into different “organs” The Flagpole concept Baie dankie vir u aandag With compliments dr Andri Nieuwoudt www.pelvicorganreconstruction.com

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