The presented model, thereby, adopts two different regions of the pubocervical and rectovaginal fascia with varying tissue compositions to describe different PF disorders mechanically (Figure 3(a)).
PCF: pubocervical fascia and RVF: rectovaginal fascia.
In the same session, rectovaginal fascia
dissection was performed from posterior vagina, and grade IV posterior prolapse was dissected broadly up to the apical region.
More distally, posterior colporraphy restores the support to the posterior wall of the vagina by correcting defects in the rectovaginal fascia
over the rectum; however, a site-specific approach obviating the need for plication may again be chosen where appropriate.
A reapproximation of the perineal body (perineorrhaphy) addresses a perineal weakness, while a plication of the rectovaginal fascia
(posterior colporrhaphy) repairs a rectocele.
Conventional colporrhaphy involving midline plication of rectovaginal fascia
carries significant risks for mid-vaginal stenosis and dyspareunia, he said.
The snow-white-colored vaginal probe makes the laparoscopic identification of the enterocele sac and its margin much easier, and thus facilitates the resection of the sac and permits easier identification of the broken edges of both pubocervical and rectovaginal fascia
A strip of AlloDerm, usually 4 by 16 cm, is sutured to the perineal body overlying the rectovaginal fascia
repair during the procedure.