A new operation technique for uterine prolapse: Vaginally-assisted laparoscopic sacrohysteropexy

Sanverdi, Ilhan; Kılıççı, Çetin; Polat, Mesut; Özkaya, Enis; Kılıç, Servet; Dizdar, Merve; Karateke, Ateş

doi:10.4274/tjod.96641

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…However, under standard cefazolin 2 g antibiotic prophylaxis, we did not encounter any graft infection or cuff cellulitis. Also there were no reported cases of mesh infection among the 229 published cases of vaginally assisted laparoscopic sacrohystero/colpopexy 9,12,13,25,26 …”

Section: Discussionmentioning

confidence: 99%

Short and middle‐term outcomes of vaginally assisted laparoscopic sacropolpopexy

Aydın

Ates

Karasu

et al. 2020

LUTS

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Objective Vaginally assisted laparoscopic sacrocolpopexy (VALS), which is a combined surgical approach where a vaginal hysterectomy is initially performed, followed by transvaginal placement of synthetic mesh and laparoscopic suspension, can be an alternative to overcome the dissection, suturing limitations of laparoscopic sacrocolpopexy. The aim of this study was to compare the operative times and middle‐term anatomic outcomes of women with uterovaginal prolapse undergoing VALS with those of women undergoing abdominal sacrocolpopexy. Methods This is a prospective cohort study that evaluates operation times, anesthesia times, estimated blood loss, middle‐term outcomes, perioperative and postoperative complications. We compared the results of 47 women who had the VALS to that of 32 abdominal sacrocolpopexy (AS). Results The mean follow up was 22.4 months for AS group and 20.5 months for VALS group. The VALS group (median 1 day) had shorter hospitalization duration than the AS group (median 3 days). The mean operation time was significantly shorter in the VALS group (125.9 minutes) than the AS group (151.9 minutes) (P = .03). There was no significant difference in perioperative and postoperative complication rates. Objective failure rate (8.5% in VALS, 15.6% in AS), subjective failure rates (6.4% in VALS, 9.4% in AS), recurrence (2.1% in VALS, 9.4% in AS) and mesh exposition rates (2.1% in VALS, 9.4% in AS) were similar in both procedures. Conclusions VALS with shorter operative time and hospitalization than conventional AS is a promising modification minimally invasive technique for sacrocolpopexy especially for those inexperienced in laparoscopic sacrocolpopexy.

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Section: Discussionmentioning

confidence: 99%

Short and middle‐term outcomes of vaginally assisted laparoscopic sacropolpopexy

Aydın

Ates

Karasu

et al. 2020

LUTS

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“…Laparoscopic hysterosacropexy has a success rate of 90%. [ 7 8 9 10 ] However, these procedures have been associated with some complications, and the most common of these complications stress urinary incontinence (SUI) and defecation disorders. [ 11 12 ] Furthermore, presacral venous plexus can be injured during the dissection of the pelvic viscera from the sacrum, and this damage may be ended with life-threatening circumstances.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Quality of Life and Female Sexual Function Following Laparoscopic Pectopexy and Laparoscopic Sacrohysteropexy in Apical Prolapse Patients

Obut

Oğlak

Akgöl

2021

Gynecology and Minimally Invasive Therapy

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Objectives: We sought to compare the surgical outcomes, safety, effectiveness, and mid-term outcomes in patients who had undergone laparoscopic hysterosacropexy and laparoscopic pectopexy due to apical prolapse. Materials and Methods: This prospective randomized study was conducted on a total of 62 women who underwent apical prolapse surgery (32 undergoing a pectopexy and 30 undergoing a sacrohysteropexy) between June 2015 and June 2017. Patients with symptomatic uterine or vaginal vault prolapse with stage 2 or worse were included in the sudy. Before and after the operation, we used the Pelvic Organ Prolapse Quantification System (POP-Q) and questionnaires, which are the Prolapse Quality of Life Questionnaire (P-QOL) and Female Sexual Function Index (FSFI), to evaluated cases. Baseline characteristics, perioperative and postoperative complications, and follow-up results at 12 months were also evaluated. Results: All domains of POP-Q, P-QOL, and FSFI scores improved significantly after surgery both in pectopexy and sacrohysteropexy group. The postoperative complications of both procedures were similar except for constipation after surgery (3.2% in the pectopexy group and 20% in the hysterosacropexy group [ P = 0.036]). Conclusion: Both sacrohysteropexy and pectopexy are effective surgical options for apical prolapse patients. The pectopexy is an acceptable alternative to laparoscopic sacrohysteropexy because of its less complexity and not reducing pelvic space for the rectum to exist. We suggest that the laparoscopic pectopexy may be widely used in clinical routine.

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“…The others put the mesh inside the pelvic cavity and then they continued their technique in a conventional style; they concluded that VALSH is a safe and effective minimally invasive procedure in uterovaginal prolapse. In the technique of Sanverdi et al, the mesh was fixed only onto the posterior face of the uterine cervix, distinct from our technique (10). We fixed the mesh onto both the anterior and posterior faces of the uterine cervix and this approach can hold the uterine axis in a more anatomical plane (3).…”

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confidence: 99%

Is vaginally assisted laparoscopic sacrohystero/colpopexy a feasible technique?

Tapisiz¹,

Doğan²,

Altınbaş³

2018

Turk J Med Sci

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To the Editor, Pelvic organ prolapse (POP) is defined as the descent of one or more of the pelvic organs, with a woman having symptoms related to the "downward displacement" of a pelvic organ. POP is very common in pre-and postmenopausal women; the lifetime risk of women undergoing a surgery for POP is about 11% and about 30% will undergo repeat surgery (1). A variety of surgical techniques including vaginal, abdominal, and laparoscopic (conventional or robotic) approaches can be used for management. Laparoscopic sacrohystero/colpopexy (LSHC) provides the potential to combine the success rates of an abdominal approach with the superiorities of minimally invasive surgery. However, LSHC requires high levels of laparoscopic operative skills and experience and is associated with longer operative times (2). In light of these data, we designed our new technique, vaginally assisted laparoscopic sacrohysterocervicopexy, with the aim of facilitating the procedure and reducing operation time, and recently we presented our technique (3). The most important part of our technique is the combination of both vaginal and laparoscopic routes and transferring the mesh to the sacral promontory by retroperitoneal tunneling (3). Eventually, the operation time was significantly reduced. This technique can also be combined with other vaginal approaches such as Manchester-Fothergill operation (4).In the literature, there are limited reports about vaginally assisted laparoscopic approaches. Among

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A new operation technique for uterine prolapse: Vaginally-assisted laparoscopic sacrohysteropexy

Cited by 5 publications

References 25 publications

Short and middle‐term outcomes of vaginally assisted laparoscopic sacropolpopexy

Short and middle‐term outcomes of vaginally assisted laparoscopic sacropolpopexy

Comparison of the Quality of Life and Female Sexual Function Following Laparoscopic Pectopexy and Laparoscopic Sacrohysteropexy in Apical Prolapse Patients

Is vaginally assisted laparoscopic sacrohystero/colpopexy a feasible technique?

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