Promedon EXIA Mode D'emploi page 5

5. Using a recommended minimum of 4 sutures, attach the 'anterior' flap of
the EXIA Y mesh to the anterior wall of the vagina. Ensure that sutures are
placed a minimum of 0.5 cm from any mesh edge.
6. Using a recommended minimum of 4 sutures, attach the 'posterior' flap of
the EXIA Y mesh to the posterior wall of the vagina. Ensure that sutures are
placed a minimum of 0.5 cm from any mesh edge.
7. Ensuring appropriate tension, attach the sacral section of the EXIA Y mesh
to the anterior longitudinal ligament at the level of the sacral promontory
using a minimum 2 fixation points.
8. Trim any excess sacral mesh proximal to the sacral attachement points, take
care to let at least 0.5 cm between the point and the edge of the mesh.
9. Reperitonealization of the mesh is mandatory.
10. It is recommended to confirm bladder and rectal integrity with cystoscopy
and a digital rectal exam.
Flat EXIA mesh:
The mesh can be used as an inlay to support fascial repair, and it can be
resized according to patient anatomy. Sutures or other means may be used to
fix the mesh in place.
Specific procedures may vary according to judgments of skilled medical
practitioners and variations in the pelvic characteristics of individual
patients. Carefully examine device prior to surgery and continuously monitor
throughout the surgical procedure to ensure the structural integrity of the
device is not compromised in any way. Good Surgical Practice must be
followed during the EXIA procedure.
• Inadequate suturing of the mesh material to the pelvic tissue may lead to
failure of the repair and recurrence of the prolapse.
• There should be an appropriate margin of at least 0.5 cm of mesh extending
beyond a suture line. Inadequate suturing of the mesh material to the pelvic
tissue may lead to failure of the repair and recurrence of the prolapse.
• Avoid excessive tension on the mesh implant during placement.
• It is recommended to confirm bladder and rectal integrity with cystoscopy
and a digital rectal exam.
POST-OPERATIVE RECOMMENDATIONS
Patients may experience some postoperative pain and transient difficulty
resuming regular defecation.
Stool-softener laxatives are routinely recommended.
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