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Laparoscopic Burch procedure for stress urinary incontinence: the Carter modification
1Advanced Surgical Education Associates, Women's Health Center of South Orange County, Inc., Mission Viejo, CA 92691, USA.
The Keio Journal of Medicine
|September 1, 1996
Summary
This study introduces a simplified laparoscopic Burch procedure for bladder neck suspension, achieving comparable long-term results to the traditional open approach. The minimally invasive technique offers efficient surgical times and encouraging outcomes in patients undergoing colposuspension.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Gynecologic Surgery
Background:
- Laparoscopic bladder neck suspension offers potential advantages over traditional open surgery.
- The Burch procedure is a standard surgical treatment for stress urinary incontinence.
Purpose of the Study:
- To describe a simplified technique for laparoscopic Burch colposuspension.
- To evaluate the efficacy and safety of this modified laparoscopic approach.
Main Methods:
- Harmonic scalpel used for bloodless dissection of the space of Retzius.
- Perivaginal tissue sutured without vaginal mucosa penetration.
- Stamey needle utilized for efficient suture placement.
- Extracorporeal knotting and stapling for peritoneal closure.
Main Results:
- Procedure performed in approximately 1 hour of surgical time.
- Encouraging results with no failures in 50 patients over two years.
- One patient required temporary suprapubic catheterization.
Conclusions:
- The simplified laparoscopic Burch procedure is effective and comparable to the classical approach.
- Minimally invasive techniques can be successfully applied to colposuspension.
- Long-term outcomes are expected to be similar to the standard Burch procedure.