Current Map of UK Trusts doing native tissue repairs* The Cumberlege Report was published earlier this year but already before then we had seen a large number of Trusts investing in reusable handles and needles for Native Tissue Repairs, or Autologous female sling repairs. BAUS has published information here, updated August 2020, and this is the link to BSUGs information published in 2018. Over 50 centers have now purchased these set of handles and needles, to ensure they have a treatment option in the meantime. The International Experience …is very different. Mesh use for surgery is continuing all over the world, and the UK is the only country where these needles and handles for Autologous Repairs are being sold so frequently. The American Urogynecologic Society (AUGS) updated their statement in support of MUS in February 2018, and has not made any changes since. You read it here. AUGS statement was supported by
- The American Association of Gynecological Laparoscopists (AAGL)
- The American College of Obstetricians and Gynecologists (ACOG)
- The National Association for Continence (NAFC)
- International Urogynecological Association (IUGA)
- The Society of Gynecologic Surgeons (SGS)
Minislings are often used around the world, to the surprise of many in the UK, as the minislings never had any real success in Great Britain.
Demo kit straight to your desk?
With choices of long vs short, thick vs thin, T-style handle or slim line handle, there are many combinations.
To ensure you get the one that works best for you, ask to see our demo kit. You will have it on your desk tomorrow, and you can have a good look at the options.
If you already know what you prefer, we can send you a quote with pricing and order details.
Training and in service of product via video link to JUNEs mock theatre
Fully equipped to do demonstrations, step by step instructions and certification training for surgeons, nurses and ODP staff, separately or in groups, led by Sam Ketley, BSc Midwifery and her staff.
“Really useful session, and great to be able to ask all those questions we seem to always have and never remember to write down!” (Feedback from attendees last week)
Step by Step Guide
A detailed and specific step by step guide outlining each part of the procedure: preparation, surgical technique, instruments and anatomy written by Dr Wael Agur in 2019.
Click here to receive a copy.
1. Positioning: Modified Lloyd Davies position to allow abdomino-perineal approach.
2. Preparation: Chlorehexidine or Betadine to prepare the skin – indwelling urethral catheter – Tagaderm to isolate the anal area – antibiotic prophylaxis as usual.
3. Incision: Mini-laparotomy – 6cm Pfannenstiel incision is enough to harvest the fascial graft.
4. Graft Harvesting: Release of subcutaneous fat to expose 1cm width of the rectus sheath. A graft of 6cm in length is harvested by undermining ½ -1 cm of the sheath starting at midline (3cm on each side) and making sure no fat or muscle attached. The harvested anterior rectus sheath graft is 6cm long and ½ – 1 cm wide, tapering to ½ cm at the edge. The procedure could either be completed under vision or the rectus sheath is closed with PDS 0 and the procedure is continued like a mid-urethral mesh tape. Continuous saline drip will keep it moist. Also covered:
5. Dissecting the retropubic space
6. Graft preparation:
7. Vaginal dissection
8. Graft Implantation
9. Cystoscopy
10. Tension Adjustment
11. Closure
12. Postoperative care
