Two Jackson urogynecologists are among few physicians in the South performing minimally invasive laparoscopic surgery to correct extensive pelvic organ prolapse.

 

Robert Harris, MD, and Steven Speights, MD, at Southeast Urogynecology at Women's Specialty Center in Jackson, are performing laparoscopic sacral colpopexy at Baptist Medical Center for pelvic organ prolapse, commonly called "dropped vagina," a condition in which one or more of the organs in the pelvic cavity, such as the uterus, vagina, bladder and/or rectum, has fallen below its normal position in the pelvis.

 

The hour-long minimally invasive procedure requires four small abdominal incisions, compared to making a large incision to open the abdomen. Physicians expand the abdomen by gently pumping gas into the abdominal cavity to improve the visual field. Then, using a laparoscope, they manipulate small instruments to lift the vagina back up to its natural position by attaching synthetic mesh from the top of the vagina to the ligament overlying the tailbone. The mesh provides the vagina with the right amount of support to keep it in the correct position and is the most sturdy and reliable repair for vaginal prolapse.

 

"This procedure is nothing new," said Harris. "Dr. Speights and I have performed thousands of these procedures over the past decade. The difference is the approach. These procedures are very demanding from a technical surgical standpoint so they are almost always done as open procedures … an abdominal incision with large retractors and much manipulation, resulting in much pain and a protracted recovery period. We've taken that exact same procedure and moved it to the laparoscopic approach. Now, these same women who had this long recovery in the past, are out of the hospital the next day, have very little pain, and are back to normal activities within a week or so rather than two or three months. 

 

"Our focus has always been on providing the best, most advanced, state-of-the-art care for women with bladder and vaginal disorders. Our focus has now turned to doing these same things in the most minimally invasive way possible, resulting in less recovery and much faster return to life … but now with a much better quality of life."

 

By using a laparoscope to suspend the vagina or the cervix to the strong tissues found deep in the pelvis, Harris and Speights avoid the large incision and extended recovery time the traditional surgery requires.

 

Harris and Speights, who specialize in the care of women with pelvic support and bladder problems including urinary incontinence, have performed more than 1,000 sacral colpopexies over the last 15 years, almost all of which have been done via the laparoscopic approach for the past two years.

 

"Vaginal prolapse is a common condition many women do not talk about," said Speights. "Women may be embarrassed to discuss their symptoms with their physicians, and there is a lack of general education. Symptoms of bladder, bowel or sexual dysfunction are frequently present. All these symptoms can have a significant impact on a woman's quality of life, which deserves attention and effective treatment."

 

Pelvic organ prolapse occurs when pelvic muscles are weakened or stretched, sometimes during vaginal childbirth, especially from a difficult labor or delivery, multiple vaginal deliveries and/or large babies. The risk increases nearly 20 percent with each additional vaginal delivery up to five births.

 

Being overweight, having a chronic cough, loss of muscle tone with aging, or having a hysterectomy or other abdominal surgery may also cause these muscles to be weakened. Heredity may play a role in determining who is predisposed toward pelvic organ prolapse.

 

Statistics suggest it occurs more often in women of Northern European and Hispanic descent than in women of African or Asian descent.

 

In a study on women's health involving nearly 30,000 women, 40 percent aged 50 to 79 years were found to have some form of pelvic organ prolapse. The symptoms include pelvic heaviness, a bulge or protrusion coming down from the vagina, and a dragging sensation in the vagina.

 

"The right treatment will depend on the type and degree of prolapse," said Harris. "For those needing surgery, performing this laparoscopically has the advantages of faster post operative recovery, shorter hospital stay and improved quality of life for the patient."