ANTERIOR, POSTERIOR AND APICAL VAGINAL WALL RECONSTRUCTION USING PORCINE GRAFTS
MJ Bonidie

OBJECTIVE: The video is a demonstration of the anatomy and techniques used to reconstruct the anterior, posterior and apical vaginal walls using porcine dermal grafts. Two trapezoidal grafts are placed, one anteriorly and one posteriorly. The anterior graft is sutured to the arcus tendineus fascia pelvis bilaterally at its lateral margin. The posterior graft is also secured to the arcus bilaterally to its mid point, and then to the pelvic sidewall down toward the perineal body. Both grafts are secured to the sacrospinous ligaments bilaterally at their apex. The grafts are also sewn together apically. The vaginal epithelium is then closed and packed in place against the dermal grafts.