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Operations: Ventro-suspension of uterus including laparoscopic ventro-suspension

Insurance code: Q2080

Introduction: This information is written by John Fairbank and is provided for the benefit of his patients. Additional information will be given during consultation in the clinic and during the pre-operative discussion. It is not appropriate for all surgeons’ individual practice or for all patients.

Purpose of operation: Ventro-suspension of the uterus is carried out in some cases of prolapse or in cases where the low or tilted position of the uterus contributes to pelvic discomfort, discomfort during sex or rarely infertility. This operation is usually done using laparoscopic techniques to allow access to the pelvis through conveniently small holes allowing for speedier recovery.

Description of procedure: A series of small incisions are made on the anterior abdominal wall. One incision is just below the umbilicus and a further incision is made above the bikini line for other instruments to pass through. The pelvis is assessed. The round ligaments which are supposed to support the top of the uterus are grasped and brought up to the anterior abdominal wall and secured to a firm layer of tissue in the anterior abdominal wall (rectus sheath) to provide long lasting support. The skin is then closed.

Anaesthetic These operations are usually carried out under general anaesthetic.

Length of stay A single night stay is typical although patients may occasionally require an extra night.

Post-operative management If a catheter has been inserted it is normally removed the following day. The IV fluid line is left in place until oral fluids are tolerated. The painkilling pump is kept in place until it is no longer required. Stitches are normally left in place to dissolve or removed five days after surgery.

Potential complications
Complications at the time of surgery include peri-operative bleeding, and damage to structures such as bladder and bowel. These complications are rare but require corrective surgery immediately or as soon as a problem is recognised. Venous thrombosis (DVT) can follow any pelvic surgery. Stockings are therefore worn and heparin injections given each day to reduce the risk. Early mobilisation and early discharge from hospital reduce the risk of thrombosis.

Post-operative consultation
A post-operative consultation is usually made for three weeks after surgery for inspection of the wounds.

Other considerations
Sex and exercise are best avoided until the skin has healed and sutures have dissolved. This may take up to four weeks. Heavy lifting is best avoided but light lifting is not a problem. Driving short distances is practical once comfortable and strong sedative pain killers are no longer being taken.

Other web sites

Information on the surgical repair of prolapse

Information on some issues related to vaginal prolapse repair surgery

Information on laparoscopy

More information on laparoscopy