Get an inside look at prolapse surgery, from technique to training to team-based care. In this episode of BackTable Women’s Health, Dr. Amy Park talks with Mayo Clinic urogynecologist and pelvic reconstructive surgeon Dr. John Occhino about the art and strategy behind prolapse repair. They explore why Dr. Occhino favors vaginal approaches, when robotics come into play, and how he frames staged treatment strategies, particularly for younger patients at risk of recurrence.

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Timestamps
00:00 - Introduction
02:09 - Choosing Vaginal vs. Robotic Approach
10:24 - Why Vaginal Skills Declined
13:20 - OR Setup and Positioning
16:32 - Anterior Entry Technique
20:05 - Ureter Safety and Suspension
28:14 - Robotic Hysteropexy Considerations
31:47 - Collaborative Training Culture
35:41 - Beyond See One Do One
46:13 - Anatomy Keeps You Safe
49:46 - Leadership Authenticity
53:45 - Team Support and Wrap Up

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More about this episode
The conversation covers how to counsel patients about prolapse as a dynamic condition, the trade-offs between durability and mesh aversion, and the importance of prioritizing symptoms and quality of life in decision-making. They share practical tips on vaginal hysterectomy technique and ergonomics, discuss why vaginal surgery skills are declining, and highlight best practices in surgical education, including apprenticeship-style training, promoting psychological safety, setting targeted goals, fostering collaboration among program directors, and grounding surgical judgment in anatomy and authenticity in leadership.

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BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.

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