A National Contemporary Analysis of Perioperative Outcomes of Open versus Minimally Invasive Sacrocolpopexy

Linder, Brian J.; Occhino, John A.; Habermann, Elizabeth B.; Glasgow, Amy E.; Bews, Katherine A.; Gershman, Boris

doi:10.1016/j.juro.2018.03.131

Cited by 57 publications

(32 citation statements)

References 18 publications

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“…We are also quite vigilant about leaving a cap of peritoneum at the apex, which we believe contributes to lower rates of vaginal exposure. Our study also echoes the findings of Linder et al, who evaluated prolonged hospitalization, transfusion, reoperation, and 30‐day complication rates in 4362 women who underwent ASC and minimally‐invasive LSC/RSC using the ACS NSQIP Database 14 . Of these women, 1179 (27%) underwent ASC.…”

Section: Discussionsupporting

confidence: 85%

Abdominal versus robotic sacral colpopexy: A detailed analysis of outcomes

McFerrin

Pilkington

Pilet

et al. 2021

Neurourology and Urodynamics

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Aims Although abdominal sacrocolpopexy (ASC) is considered the gold standard for surgical repair of vaginal vault prolapse, the open surgical approach has significant morbidity. We aim to compare anatomic and functional outcomes in women receiving either robotic‐assisted sacral colpopexy (RSC) or ASC for post‐hysterectomy prolapse. Methods We present a retrospective chart review of all women who underwent ASC and RSC at our institution and had 12‐month follow‐up (FU). Pelvic organ prolapse quantification (POP‐Q) staging was assessed both preoperatively and postoperatively. Perioperative and demographic details were collected from the medical records. Results One hundred twenty four women underwent RSC (mean age 63, median FU 16 months). Those in the ASC group (n = 144) were statistically younger (mean age 60) and had longer FU (median 60 months). Both median day of successful voiding trial and discharge day significantly favored RSC. There were no Clavien Grade IV/V complications for either procedure and three RSC procedures were converted to ASC. Both approaches were associated with a significant improvement in POP‐Q stage at FU, with few women requiring additional surgery. Overall, 76% of women in each group were dry from stress urinary incontinence. Improvement in storage and emptying indices, dyspareunia, and quality of life measures was observed after both approaches. Conclusion RSC demonstrates good support of significant vaginal vault prolapse at medium term FU, with shorter hospital stays and low complication rates. Close FU after RSC over a longer period will be needed to fully assess durability of both functional and anatomic outcomes.

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Section: Discussionsupporting

confidence: 85%

Abdominal versus robotic sacral colpopexy: A detailed analysis of outcomes

McFerrin

Pilkington

Pilet

et al. 2021

Neurourology and Urodynamics

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“…13,22,23 The reoperation rate was 2.37%, which was similar to other studies in the literature. [24][25][26][27] In all 5 cases, the pelvis was clear of adhesions with the added advantage of not having to remove an old mesh. The operative time required for the repeat sacrocolpopexy was about the same to *30 minutes longer, and most of the time it was possible to use the same laparoscopic incisions.…”

Section: Karon and Chatterjeementioning

confidence: 96%

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

Karon

Chatterjee

2019

Journal of Gynecologic Surgery

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Objective: This study was conducted to evaluate the use of non-crosslinked acellular dermal matrix (ADM) in laparoscopic sacrocolpopexy by analyzing clinical outcomes and patient-satisfaction surveys. Materials and Methods: Two hundred and eleven patients underwent laparoscopic sacrocolpopexy for pelvic organ prolapse (POP) between January 6, 2012, and December 31, 2017. Each patient had her pelvic-floor measurements diagrammed with the POP-Q [Quantification] system using the interactive tool provided by the American Urogynecologic Society. The Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7), used to make comprehensive assessments of women with urogynecologic problems, were mailed to all patients. If responses were not received, the patients were contacted by telephone. Patients who were not reached by either mail or telephone had their charts individually reviewed to extract the information. Trained surveyors scored the PFDI-20 and the PFIQ-7 questionnaires. The de-identified data were analyzed for patient satisfaction and outcomes. This information was obtained by a review of patient charts at 4-week postoperative and annual examinations; any phone calls with complaints and/or problem office visits were noted. Biopsies from the sacrocolpopexy area were taken if a patient had another incidental gynecologic procedure unrelated to the prolapse or at the time of repeat sacrocolpopexy for POP and the paraffin cell block was sent to McGowan Institute for Tissue Regeneration. Results: One hundred and five patients responded to the survey. Charts were completed for 106. The majority of interviewed patients stated that they were doing a ''little better'' or ''much better'' (77/88; 87.5%). The thirdquartile PFDI-20 score was 93 with a median of 60 and the PFIQ-7 score was 43 with a median of 29. Five patients underwent reoperations (4.76%). The most-common postoperative complaint was overactive bladder symptoms, followed by vaginal discharge. Histology showed either a lack of regenerative healing tissue at the failure site or good results showing neovascularization and a presence of connective and ligamentous tissue around the matrix. No intense fibrosis or neoplastic formation was reported. Conclusions: A non-crosslinked ADM patch can be a good alternative to synthetic polypropylene mesh in patients undergoing sacrocolpopexy for POP. ( J GYNECOL SURG 35:337)

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“…Open SC has been the gold standard procedure for patients with apical POP, with long-term cure rates reaching 90% [ 6 , 7 , 8 ]. The use of minimally invasive SC (MISC), including laparoscopic SC (LSC) and robotic SC (RSC), has been increasing, and large clinical data indicate that LSC is replacing open SC as the gold standard procedure as it provides low recurrence rates and low comorbidity rates similar to those of open surgery [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

New “Wrinkle Method” for Intracorporeal Anterior Vaginal Wall Plication during Sacrocolpopexy

Lee

Kim

et al. 2021

JCM

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In this study, we introduce a new wrinkle method for intracorporeal anterior vaginal wall plication during sacrocolpopexy for pelvic organ prolapse (POP) aiming to decrease POP recurrence and postoperative vaginal wall mesh erosion. The wrinkle method was performed using robotic sacrocolpopexy (RSC) on 57 symptomatic POP patients. Sixty-six patients underwent conventional RSC before the development of the wrinkle method. Feasibility and perioperative outcomes were compared. The wrinkle method is not time consuming. The total operative time was shorter in the wrinkle group than in the non-wrinkle group; however, this was attributed to lower adhesiolysis in the wrinkle group. No differences were recorded in the mean estimated blood loss and complication rates between the two groups. In conclusion, although we were unable to confirm that the wrinkle method decreased POP recurrence and vaginal wall mesh erosion after RSC because of the short follow-up period, our preliminary findings are positive in terms of safety. Further long-term well designed randomized controlled trials are required to elucidate the benefits of the wrinkle method.

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A National Contemporary Analysis of Perioperative Outcomes of Open versus Minimally Invasive Sacrocolpopexy

Abstract: Minimally invasive sacrocolpopexy was associated with reduced rates of 30-day complications, blood transfusion, prolonged hospitalization and hospital readmission compared to abdominal sacrocolpopexy.

Cited by 57 publications

References 18 publications

Abdominal versus robotic sacral colpopexy: A detailed analysis of outcomes

Abdominal versus robotic sacral colpopexy: A detailed analysis of outcomes

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

New “Wrinkle Method” for Intracorporeal Anterior Vaginal Wall Plication during Sacrocolpopexy

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