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

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.