Cystocele repair with single-incision, trocarless mesh system

Introduction and hypothesis: The use of mesh at the time of anterior vaginal wall repair reduced the risk of recurrent anterior vaginal wall prolapse. The aim of our video is to demonstrate our dissection technique focusing on the main anatomical landmarks in the pelvis and present an overall safer system to correct pelvic floor prolapse. Methods: The video demonstrates correction of cystocele with the EndoFast Reliant™ system (IBI Israel Biomedical Innovations, Caesarea Industrial Park South, Israel). The surgical technique is described. Results: Twenty-nine patients were treated with the system. Mean follow-up was 10 (range, 6-30) months. At latest follow-up, favorable anatomical results were obtained for 26 of 29 patients (89.6%); three patients presented stage 1 nonsymptomatic prolapse. Three cases (13%) of de novo stress urinary incontinence (SUI) and two cases of de novo urgency (6.9%) were diagnosed and treated. Postoperative voiding difficulties, dyspareunia, or pain were not observed. Conclusion: The operation with the trocarless system was found to be safe, easy to learn and implement, and have the potential for reducing intra- and postoperative complications, with very satisfactory functional and anatomical results.