Η παρουσίαση φορτώνεται. Παρακαλείστε να περιμένετε

Η παρουσίαση φορτώνεται. Παρακαλείστε να περιμένετε

TVT TVT-O TVT-S needless ΦΑΤΛΕΣ Κ. ΓΕΩΡΓΙΟΣ ΧΕΙΡΟΥΡΓΟΣ ΟΥΡΟΛΟΓΟΣ ΟΥΡΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΙΠΠΟΚΡΑΤΕΙΟΘΕΣΣΑΛΟΝΙΚΗ.

Παρόμοιες παρουσιάσεις


Παρουσίαση με θέμα: "TVT TVT-O TVT-S needless ΦΑΤΛΕΣ Κ. ΓΕΩΡΓΙΟΣ ΧΕΙΡΟΥΡΓΟΣ ΟΥΡΟΛΟΓΟΣ ΟΥΡΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΙΠΠΟΚΡΑΤΕΙΟΘΕΣΣΑΛΟΝΙΚΗ."— Μεταγράφημα παρουσίασης:

1 TVT TVT-O TVT-S needless ΦΑΤΛΕΣ Κ. ΓΕΩΡΓΙΟΣ ΧΕΙΡΟΥΡΓΟΣ ΟΥΡΟΛΟΓΟΣ ΟΥΡΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΙΠΠΟΚΡΑΤΕΙΟΘΕΣΣΑΛΟΝΙΚΗ

2 Stress Incontinence causes Urethral hypermobility Urethral hypermobility a common cause of SUI, a common cause of SUI, refers to significant displacement of the urethra (and bladder neck) during physical exertion when abdominal pressure is increased Hypermobility decreases pressure transmission and results in leakage of urine Hypermobility decreases pressure transmission and results in leakage of urine Staskin DR. In: Cardozo L, Staskin DR, eds. Textbook of female urology and urogynaecology, 2001 p. 84-9

3 Stress Incontinence causes ISD is another common cause of SUI. ISD is another common cause of SUI. The urethra does not contract sufficiently and as a consequence it does not close completely. The urethra does not contract sufficiently and as a consequence it does not close completely. This permits leakage even with minimal stress / increase in abdominal / bladder pressure. This permits leakage even with minimal stress / increase in abdominal / bladder pressure. Φυσιολογική σύγκλιση Παθολογική σύγκλιση Staskin DR. In: Cardozo L, Staskin DR, eds. Textbook of female urology and urogynaecology, 2001 p. 84-9

4 Anti-incontinence Surgery: Past Anti-incontinence Surgery: Past

5 Anti-incontinence Surgery: Recent Past Acta Scand Obstet Gynecol 1990 The integral theory of female pelvic floor Petros, Ulmsten

6 The “Evolution” of Treatment for Female SUI Kelly Needle Suspension Burch Autologous Sling 1990’sTVTRetropubic 2003-TVTObturator TVT Secur Next Generation? NEEDLESS;

7 15 to 25 Min 15 to 25 Min Day-care Day-care Rehabilitation: 3 to 7 days Rehabilitation: 3 to 7 days 6% Bladder penetration 6% Bladder penetration 5% P/O BOO (ΕΠΙΣΧΕΣΗ) 5% P/O BOO (ΕΠΙΣΧΕΣΗ) Intestinal / vessel iatrogenic injury Intestinal / vessel iatrogenic injury TVT – 615 publications

8 TVT- Obturator Jean de-Leval (inside-out) Jean de-Leval (inside-out) No cystoscopy No cystoscopy TVT TVT-O

9 TVT-O System

10 TVT-Obturator - 47 publications 7 to 15 Min 7 to 15 Min Daycare Daycare 3 to 5 days to recover 3 to 5 days to recover Skin cut Skin cut Thigh pain of 1-7 days – 30% Thigh pain of 1-7 days – 30% 3% of P/O BOO (ΕΠΙΣΧΕΣΗ) 3% of P/O BOO (ΕΠΙΣΧΕΣΗ)

11 TVT-SECUR The TVT Secur was designed to minimize the operative procedure as much The TVT Secur was designed to minimize the operative procedure as much as possible in order to reduce those undesired complications as possible in order to reduce those undesired complications This new device is composed of an 8 cm long laser cut polypropylene mesh and is introduced to the internal Obturator muscle (Hammock position) by a metallic inserter, while no exit skin cuts are needed. This new device is composed of an 8 cm long laser cut polypropylene mesh and is introduced to the internal Obturator muscle (Hammock position) by a metallic inserter, while no exit skin cuts are needed. This approach imitates the sub- mid-urethral support provided This approach imitates the sub- mid-urethral support provided with the TVT-Obturator, yet imitating the TVT is possible as well, by introducing the TVT-SECUR arms retropubically rather than to the Obturator area. with the TVT-Obturator, yet imitating the TVT is possible as well, by introducing the TVT-SECUR arms retropubically rather than to the Obturator area.

12 TVT SECUR

13 TVT Secur Placement

14

15

16 3 to 7 Min Day care Day care 2 to 4 days to recover 2 to 4 days to recover No skin cut No skin cut Minimal pain Minimal pain No P/O BOO No P/O BOO TVT SECUR

17 The novel TVT-SECUR procedure for the treatment of female stress urinary incontinence is safe and simple to perform. The novel TVT-SECUR procedure for the treatment of female stress urinary incontinence is safe and simple to perform. The very early therapeutic effectiveness is promising, yet long term data is essential prior to drawing any recommendations. The very early therapeutic effectiveness is promising, yet long term data is essential prior to drawing any recommendations.

18 Conclusions Η Stress ακράτεια είναι μια κοινή και ψυχοφθόρα κατάσταση Η Stress ακράτεια είναι μια κοινή και ψυχοφθόρα κατάσταση Διεξοδικός έλεγχος για τη διάγνωση πριν τη θεραπεία. Διεξοδικός έλεγχος για τη διάγνωση πριν τη θεραπεία. Εξατομίκευση θεραπείας Εξατομίκευση θεραπείας Τάσεις για less invasive surgery έχουν ελαττώσει την νοσηρότητα και την παραμονή στο νοσοκομείο. Τάσεις για less invasive surgery έχουν ελαττώσει την νοσηρότητα και την παραμονή στο νοσοκομείο. Η ακράτεια πρέπει να πάψει να θεωρείται φυσιολογική συνέπεια του γήρατος, Η ακράτεια πρέπει να πάψει να θεωρείται φυσιολογική συνέπεια του γήρατος, Η stress ακράτεια πρέπει να αντιμετωπίζεται σαν μια θεραπεύσιμη νόσος. Η stress ακράτεια πρέπει να αντιμετωπίζεται σαν μια θεραπεύσιμη νόσος.

19 Our experience Surgical outcomes Surgical outcomes

20 ΕΥΧΑΡΙΣΤΩ!!!


Κατέβασμα ppt "TVT TVT-O TVT-S needless ΦΑΤΛΕΣ Κ. ΓΕΩΡΓΙΟΣ ΧΕΙΡΟΥΡΓΟΣ ΟΥΡΟΛΟΓΟΣ ΟΥΡΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΙΠΠΟΚΡΑΤΕΙΟΘΕΣΣΑΛΟΝΙΚΗ."

Παρόμοιες παρουσιάσεις


Διαφημίσεις Google