Laparoscopic Two-Team Sling for Stress Urinary Incontinence

The two-team sling procedure is recommended for women with recurrent stress urinary incontinence (SUI), particularly those with low urethral pressures. These procedures have been performed for 20 years using a combined abdominovaginal approach and Marlex mesh. From July 1993 to February 1996, 100 cases of laparoscopic two-team procedures were performed using both extraperitoneal and intraperitoneal approaches. An overall success rate of 95% was achieved with a mean follow-up of 1.5 years (range 6 mo-3 yrs). Complications were small bowel perforation (1%) from the umbilical cannula requiring laparotomy and small bowel resection, inadvertent cystotomy (3%), voiding dysfunction (3%), and mesh erosion (3%). The mean operating time was 70 minutes and average length of hospital stay was 1.5 days. The laparascopic two-team sling is a suitable surgical alternative for women with recurrent SUI.