LESS Sacrocolpopexy: step by step of a simplified knotless technique

Introduction:This series of cases was an investigation of the safety and feasibility of robotic laparoendoscopic single-site surgery (R-LESS) as a method of performing sacrocolpopexy.Case Presentation:This is a retrospective series of 15 cases of R-LESS sacrocolpopexy with the V-Loc (Medtronic, Minneapolis, Minnesota, USA) suture and a retroperitoneal tunneling technique performed by a single surgeon, combined with a literature review. Patient demographic information and perioperative data were analyzed. The standard robotic sacrocolpopexy steps were followed, but the surgeon used a combined technique of V-Loc suture and retroperitoneal tunneling to simplify the procedure. No additional ports were necessary in any of the patients.Management and Outcome:Using the pelvic organ prolapse quantification (POP–Q) scoring method, the mean preoperative C-point of the 15 patients was +1.16 compared to the mean immediate postoperative C-point, which was −5.5. The mean total sacrocolpopexy time was 74.7 (range, 50–99) minutes and mean mesh anchoring time was 22.60 ± 3.85 minutes. The mean sacral promontory fixation and tunneling and mesh position times were 11.87 ± 3.02 and 5.80 ± 2.14 minutes, respectively. All 15 cases were performed without perioperative or long-term complications.Discussion:R-LESS in combination with the V-Loc suture and the retroperitoneal tunneling technique can be safely and feasibly performed, especially in sacrocolpopexy and, potentially, in other POP surgeries. With adequate and systematic training, surgeons can acquire the necessary skills to perform this complex surgical procedure.

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“…After that, more and more gynecologic surgeries were reported to be feasible, including sacrocolpopexy. 13 , 17 – 19 …”

Section: Discussionmentioning

confidence: 99%

Robotic Single-Site Sacrocolpopexy with Retroperitoneal Tunneling

Liu

Bardawil

Zurawin

et al. 2018

JSLS

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“…Comparing the algorithm performance of BCNN-R and BCNN-S with that in References [22][23][24], the highest accuracy of BCNN-S was 88.98%, followed by 85.62% of BCNN-R. BCNN-R had the highest recall rate of 88.51%, followed by BCNN-S Computational and Mathematical Methods in Medicine of 87.54%; the highest accuracy of BCNN-R was 97.34%, followed by 91.67% of BCNN-S (Figure 4).…”

Section: Algorithm Performance Comparisonmentioning

confidence: 99%

Ultrasound Evaluation of Pelvic Floor Function after Transumbilical Laparoscopic Single-Site Total Hysterectomy Using Deep Learning Algorithm

Zhu

Zhang

et al. 2022

Computational and Mathematical Methods in Medicine

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This study was aimed at investigating the ultrasound based on deep learning algorithm to evaluate the rehabilitation effect of transumbilical laparoscopic single-site total hysterectomy on pelvic floor function in patients. The bilinear convolutional neural network (BCNN) structure was constructed in the ultrasound imaging system. The spatial transformer network (STN) was used to preserve image information. Two algorithms, BCNN-R and BCNN-S, were proposed to remove sensitive information after ultrasonic image processing, and then, subtle features of the image were identified and classified. 80 patients undergoing transumbilical laparoscopic single-site total hysterectomy in hospital were randomly divided into a control group and a treatment group, with 40 cases in each group. In the control group, conventional ultrasound was used to assess the image of pelvic floor function in patients undergoing laparoendoscopic single-site surgery (LESS); in the observation group, ultrasound based on deep learning algorithm was used. The postoperative incision pain score, average postoperative anus exhaust time, average hospital stay, and postoperative satisfaction of the two groups were evaluated, respectively. The highest accuracy of constructed network BCNN-S was 88.98%; the highest recall rate of BCNN-R was 88.51%; the highest accuracy rate of BCNN-R was 97.34%. The operation time, intraoperative blood loss, and exhaust time were similar between the two groups, and the difference had no statistical significance ( P > 0.05 ). The numerical rating scale (NRS) scores were compared, the observation group had less pain, the difference between the two groups had statistical significance ( P < 0.05 ), and the postoperative recovery was good. The BCNN based on deep learning can realize the imaging of the uterus by ultrasound and realize the evaluation of pelvic floor function, and the probability of pelvic floor dysfunction is small, which is worthy of clinical promotion.

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“…Therefore, very few LESS sacrocolpopexies have been reported, and the surgeries that have been reported were performed with a simplified knotless technique involving polymeric clips rather than sutures. 7 Herein, I describe our initial clinical experience with and technique for RSS sacrocolpopexy.…”

Section: Introductionmentioning

confidence: 99%

Robotic Single-Site® Sacrocolpopexy: First Report and Technique Using the Single-Site® Wristed Needle Driver

Lee

2016

Yonsei Med J

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The recently introduced da Vinci Single-Site® platform offers cosmetic benefits when compared with standard Multi-Site® robotic surgery. The innovative endowristed technology has increased the use of the da Vinci Single-Site® platform. The newly introduced Single-Site® Wristed Needle Driver has made it feasible to perform various surgeries that require multiple laparoscopic sutures and knot tying. Laparoscopic sacrocolpopexy is also a type of technically difficult surgery requiring multiple sutures, and there have been no reports of it being performed using the da Vinci Single-Site® platform. Thus, to the best of our knowledge, this is the first report of robotic single-site (RSS) sacrocolpopexy, and I found this procedure to be feasible and safe. All RSS procedures were completed successfully. The mean operative time was 122.17±22.54 minutes, and the mean blood loss was 66.67±45.02 mL. No operative or major postoperative complications occurred. Additional studies should be performed to assess the benefits of RSS sacrocolpopexy. I present the first six cases of da Vinci Single-Site® surgery in urogynecology and provide a detailed description of the technique.

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LESS Sacrocolpopexy: step by step of a simplified knotless technique

Abstract: LESS sacrocolpopexy performed with conventional instruments is feasible and a safe procedure reproducing surgical steps of conventional laparoscopic or robotic surgery.

Cited by 3 publications

References 0 publications

Robotic Single-Site Sacrocolpopexy with Retroperitoneal Tunneling

Robotic Single-Site Sacrocolpopexy with Retroperitoneal Tunneling

Ultrasound Evaluation of Pelvic Floor Function after Transumbilical Laparoscopic Single-Site Total Hysterectomy Using Deep Learning Algorithm

Robotic Single-Site® Sacrocolpopexy: First Report and Technique Using the Single-Site® Wristed Needle Driver

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