Short-term Outcomes of Non-robotic Single-incision Laparoscopic Sacrocolpopexy: A Surgical Technique

Abstract

Study Objective: Our main purpose was to describe the surgical technique and short-term outcomes of single-incision laparoscopic sacrocolpopexy (S-LSC) for the treatment of pelvic organ prolapse (POP). Design: This study consisted of a retrospective analysis of 49 consecutive cases. Setting: This study was set at the Third Affiliated Hospital of Guangzhou Medical University from October 2016 to November 2017. Patients: The population for this study consisted of women with stage II to IV POP who met eligibility criteria for laparoscopic surgery. Interventions: S-LSC included the use of V-loc barbed suture and retroperitoneal tunneling, in addition to standard singleincision laparoscopic surgery techniques. All 49 cases were successfully completed. All cases included concomitant procedures; 42 (85.7%) had removal of the uterus and adnexa. The main measured outcomes include patient characteristics, perioperative outcomes, and change in pelvic floor support (Pelvic Organ Prolapse Quantification System), and quality of life (Pelvic Floor Impact Questionnaire). Measurements and Main Results: All patients were parous, and 42.9% had a history of previous abdominal surgery. The mean operative duration from skin to skin was 201.20 § 46.53 minutes. The mean estimated blood loss was 27.0 § 16.6 mL. The mean pre-and post-operative Pelvic Organ Prolapse Quantification System scores were 2.2 § 1.1 cm versus À 2.6 § 0.5 cm for the Aa point and 3.2 § 2.8 cm versus À4.6 § 0.8 cm for the C point (p <.05 for both). The mean pre-and post-operative Pelvic Floor Impact Questionnaire scores were 106.4 § 18.9 versus 8.9 § 4.26 (p <.05), suggesting that S-LSC significantly improved physical prolapse and quality of life. Four patients suffered from postoperative complications (3 mesh exposure and 1 lumbosacral pain). Six patients complained of new onset of stress urinary incontinence. Conclusions: Single-incision laparoscopic sacrocolpopexy is a feasible method to manage POP. However, the long-term effects and complications need to be further investigated.

Permanent Compared With Absorbable Suture in Apical Prolapse Surgery

“…Thirty-nine studies with 3,349 patients met inclusion criteria for the sacrocolpopexy category. Three compared both suture types, 9,39,40 and 36 used one suture type (20 permanent 41–60 and 16 absorbable 8,61–75 ); 2,045 patients underwent sacrocolpopexy with permanent suture, and 1,304 with absorbable suture. Overall, nine studies were RCTs, 12 were comparative (two prospective, nine retrospective, one unclear direction), and 18 were single-arm (six prospective, 12 retrospective).…”

Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study

“…In our previous research, we reported that vNOTES-SC [ 5 , 26 ] and LESS-SC [ 6 ] had good short-term clinical efficacy after the operation; however, data analysis and comparison of the differences between the two techniques were not performed. Thus, further observation of the mid- and long-term follow-up outcomes was required.…”

“…Sacral hysteropexy was first reported as early as 1957 by Arthure et al [ 3 ], while Nezhat et al [ 4 ] published the first case of laparoscopic sacrocolpopexy (LSC) in 1994. Subsequently, surgical routes for sacrocolpopexy have diversified with the rapid development and extensive application of minimally invasive techniques, including LSC with or without robot assistance, transvaginal natural orifice transluminal endoscopic sacrocolpopexy (vNOTES-SC) [ 5 ], and laparoendoscopic single-site sacrocolpopexy (LESS-SC) [ 6 ]. Currently, only a few studies have investigated the clinical application and efficacy of vNOTES-SC and LESS-SC.…”