ISGE Newsletter

Autor information

  • Guenter K. Noé

Abstract

In 1910 the fixation of the vaginal apex to the promontory was described by Otto Kuestner [1, 2]. Via a laparotomy the cuff was sutured to the right side of the promontory. In most cases the vagina was stretched extremely with negative effects to the continence and resulting in enteroceles.

G.A. Williams and A.C. Richardson in 1952 described an approach by using the aponeurosis fascia for the fixation of the apex. After a horizontal laparotomy the fascia was dissected in to stripes of 1cm. The stripes were led around the rectus muscle lateral and sutured to the vaginal apex. As the fascia measured 7-8 cm maximal a relevant ventralisation resulted with a high risk of enterocele development. Heidenreich und Greve reported a success rate of 64% in 2009 [3].

Lane first described the implementation of mesh for sacral colpopexy in 1962 [4]. This enabled the surgeons to fix the vagina with low tension and in the natural position. One year later Ulfelder reported the successful performance of the same approach [5]. In the following years multiple variations were reported and many application studies have been published over decades [6-8]. Still Sacro-Colpopexy is defined the “Gold Standard” as reference for new approaches.

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