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Correct needle insertion sidesteps vascular injury. (Avoid Lateral Rotation).
CHICAGO -- Aim for the patient's shoulder, and don't rotate the needle laterally.
Those two pieces of advice for performing the tension-free vaginal tape (TVT) insertion procedure were offered by Dr. Tristi W.Muir at the annual meeting of the American Urogynecologic Society.
The TVT, a relatively new treatment for female urinary incontinence that involves placement of a proline mesh sling underneath the mid-urethra, has become extremely popular in Europe and the United States. Nearly 200,000 procedures have been performed worldwide since the technique became available in 1996.
The TVT offers several advantages over other sling procedures: It can be done under local anesthesia, operating time is only about 30 minutes, patients can void right away and there is minimal anatomic distortion because the tape is loosely placed.
However, TVT placement is tricky because the needle must be blindly inserted upward into the vagina, thereby increasing the risk for vascular injury "It's an excellent procedure with a good cure rate, but people need to be careful and be aware that serious complications can occur. The surgeon must understand the vascular anatomy of the retropubic space and anterior abdominal wall," said Dr. Muir, a urogynecologist at the Cleveland Clinic ...
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...the onset of resistance ([R.sub.1]) and limit of lateral rotation ROM (L) perceived by the therapist. Lines were drawn...by the therapist as the shoulder was moved farther into lateral rotation. Although no comparisons of these lines were made, the...
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- Frederick County jury awards $1.37M for vascular injury.
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Byline: Steve Lash A Frederick County jury has awarded nearly $1.37 million to a woman who suffers chronic leg pain and must take a daily dose of blood thinner after a diagnostic test left her with vascular injuries three years ago. The jury found that Dr. Gerrit J. Schipper's negligent
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Source: HighBeam Research, Correct needle insertion sidesteps vascular injury. (Avoid Lateral...