Skip to main content

Raz-Pereyra Trocar

The Raz-Pereyra trocar is a ligature / fascia-carrying trocar used during pubovaginal (autologous rectus fascia) sling placement for female stress urinary incontinence.

Design​

  • Long metal trocar with a beveled or forked distal end for capturing suture / fascia strip
  • Passed through the retropubic space between the rectus fascia above and the anterior vaginal wall below
  • Available in several variants (different tip shapes, curves, lengths)

How It Is Used​

In a standard autologous rectus fascia pubovaginal sling:

  1. A segment of rectus fascia is harvested through a small suprapubic incision and prepared with suture at each end
  2. A small anterior vaginal wall incision is made and the retropubic space is developed bilaterally
  3. The Raz-Pereyra trocar is passed from the suprapubic incision, through the rectus fascia, down through the retropubic space, and out through the vaginal incision — on each side
  4. The suture tails at each end of the fascial strip are captured by the trocar tip and delivered upward through the retropubic space to the abdominal wound
  5. The sling is tensioned at the mid-urethra and the fascia-anchoring sutures are tied over the rectus fascia

The trocar serves as the passage device that translates the sling arms from the vaginal working field to the abdominal anchoring point through a defined transfascial retropubic path.

Lineage — Raz and Pereyra​

  • Armand Pereyra (Long Beach) described the original 1959 needle suspension for SUI — a precursor technique that used a similar transfascial needle passage.
  • Shlomo Raz (UCLA) refined and popularized the modern autologous rectus fascia pubovaginal sling, with modifications of the trocar that now bear his name alongside Pereyra's.
  • Raz is also the informal head of the URPS Raz lineage — see Surgical Genealogy.

Contemporary Relevance​

Autologous rectus fascia pubovaginal slings remain the gold-standard salvage operation for complex female SUI (particularly after failed mesh sling, failed Burch, intrinsic sphincter deficiency), a continuing mainstay of urogynecologic practice even as synthetic mid-urethral slings have dominated the primary-operation landscape. The Raz-Pereyra trocar — or a functional equivalent — is indispensable to that operation.

See also: Female Urethra, The Retropubic Space, Surgical Genealogy.