[Pelviperineoscopy. Preliminary study of feasibility on cadavers]

Area of Science:

• Minimally Invasive Surgery
• Pelvic Reconstructive Surgery
• Surgical Anatomy

Context:

• Traditional vaginal access for pelvic organ prolapse (POP) surgery carries risks like mesh exposure and prolonged recovery.
• Endoscopic techniques offer potential advantages in minimizing surgical trauma and improving patient outcomes.
• Evaluating novel surgical approaches is crucial for advancing POP treatment.

Purpose:

• To assess the feasibility of a novel endoscopic perineal access technique, termed pelvi-perineoscopy, for pelvic reconstructive surgery.
• To evaluate the ability to dissect key anatomical structures relevant to sacrospinofixation and posterior mesh placement via this endoscopic route.
• To identify potential complications and assess the safety profile of the pelvi-perineoscopy approach in a cadaveric model.

Summary:

• A cadaveric feasibility study involving endoscopic dissection of the pararectal space and rectovaginal septum was conducted.
• The pelvi-perineoscopy technique allowed for visualization of the sacrospinous ligament and pudendal nerve in most cases.
• Incidents included rectal, vaginal, and pudendal pedicle injuries, attributed to initial inexperience.

Impact:

• This endoscopic perineal access may enable sacrospinofixation or posterior mesh placement without colpotomy, potentially reducing mesh exposure and recovery time.
• Further evaluation and refinement of the pelvi-perineoscopy technique are warranted.
• This approach could offer a less invasive alternative for specific pelvic organ prolapse repairs.