The anatomy and an illustrated description of a technique for combined laparoscopic and vaginal total removal of an obturator mid urethral tape

Abstract

To date complete excision of a mid-urethral obturator tape has required vaginal and groin exploration—a morbid procedure. We detail the theoretical anatomy and describe the operative technique for the first ever combined laparoscopic and vaginal complete excision of mid-urethral obturator tape. This procedure was successfully performed in a 65-year-old female along with simultaneous laparoscopic redo colposuspension with complete removal of mid-urethral obturator tape and successful resolution of all symptoms including stress urinary incontinence. It is possible for an experienced laparoscopic and vaginal surgeon working in tandem to completely remove a mid-urethral obturator tape without the need for groin dissection. This is the first description of this technique.