経腟的腹腔鏡（vNOTES）を用いた仙骨子宮靱帯縫縮による腟断端挙上術

抄録

　Over the past few years, laparoscopic colposuspension has become an option as native tissue repair (NTR) surgery for pelvic organ prolapse, but there is no established surgical procedure. Reported here is a colposuspension technique involving reefing of the uterosacral ligaments via vaginal nature orifice transluminal endoscopic surgery (vNOTES) that we performed at this facility. After hysterectomy using vNOTES, guide sutures are laparoscopically placed in both uterosacral ligaments (USL), and the sutures are pulled tight against the abdominal wall to lift the ligaments, completing the vNOTES procedure. Using the USL traction suture as a guide, the ligaments are then sutured with non-absorbable sutures and secured to the vaginal stump via a transvaginal procedure. This technique enables visualization of the procedure and it has a low risk of serious surgical complications. The vaginal stump is elevated in an anatomically appropriate direction, and the non-absorbable sutures should remain effective for a prolonged period. This procedure is useful in treating pelvic organ prolapse in the form of uterine prolapse.