TOT

Surgical Synopsis-TOT Sling

TOT Sling Figures 2 and 3

Step 1. Small incision is made under
Step 2. Vaginal epithelium is dissected free the urethra

TOT Sling Figures 4 and 5

Step 3. Area of groin incision located 1cm
Step 4. Finger placed in vaginal incision inferior to adductor longus tendinous to guide needle. Needle placed in insertion (level of clitoris) groin incision and passed

TOT Sling Figure 6

TOT Sling Figure 7

TOT Sling Figures 8 and 9

Step 5. The needle is brought through the vaginal incision and the tape is attached to the needle with the connector.

TOT Sling Figure 10

TOT Sling Figure 11

Step 6. Connected tape is then brought back through the groin incision.

TOT Sling Figures 12 and 13

Step 7. Needle and tape is passed on the opposite side. Tape is then adjusted with an intra-operative cough test and adjusted until no leakage occurs. Excess mesh is cut off at the groin incisions and these are closed with steri-strips and vaginal incision is closed with absorbable suture.

TOT Sling Figures 14