Twenty years of laparoscopic sacrocolpopexy: where are we now?

Gabriel, Boris; Nassif, Joseph; Barata, Sónia; Wattiez, Arnaud

doi:10.1007/s00192-011-1361-z

Cited by 25 publications

(14 citation statements)

References 13 publications

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“…The laparoscopic suspension is much easier and only takes 30 minutes to accomplish, as we have reported previously . However, for LSH/LSC, the average operation time is 2–3 hours even when done by experienced surgeons; the prolonged pneumoperitoneum and Trendelenburg position put a strain on the circulation during the operation, especially for seniors or patients with CVD, who present a difficult surgical field and cannot endure long operation times.…”

Section: Discussionmentioning

confidence: 92%

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Liang

Chen

Deng

et al. 2017

BJOG

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Objective To compare the safety and effectiveness of two different materials (mesh and suture line) used in laparoscopic extraperitoneal uterine suspension.Design A retrospective observational study.Setting Gynaecology departments in two hospitals in China.Population Women with symptomatic pelvic organ prolapse (POP) of stage II or higher.Methods The women were divided into two groups according to the two different materials for laparoscopic extraperitoneal uterine suspension: mesh or suture line. The baseline characteristics, perioperative details, complications, objective and subjective indexes of the two groups were compared.Main outcome measures The primary outcome was subjective satisfaction rate based upon validated questionnaires. The secondary outcome was objective anatomic assessment with the POP-Q system.Results No difference was found in baseline characteristics and perioperative details except that there were more cases of cardiovascular disease (CVD) and associated other surgeries in the Line than the Mesh group (36 versus 19, P < 0.05; 12 versus 2, P < 0.05). Statistically significant improvements were found in anatomical measures of points Aa, Ba, Ap, Bp, C and TVL (P < 0.01), as well as functional and quality-of-life measures (P < 0.01 for PFDI-20 and PFIQ-7) between both groups. The postoperative PFDI-20, PFIQ-7 and PGI-I scores were not different between two groups (P > 0.05). Two cases of deep wound infection were observed in Mesh group at 3-month follow up.Conclusions Laparoscopic extraperitoneal linear uterine suspension is easy to perform and is associated with fewer meshrelated complications. It is more secure, especially in elderly women and in those with physical complications.Keywords Laparoscopic, mesh, uterine prolapse, uterine suspension.Tweetable abstract Laparoscopic extraperitoneal linear uterine suspension is safe, with fewer mesh-related complications.

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Section: Discussionmentioning

confidence: 92%

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Liang

Chen

Deng

et al. 2017

BJOG

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“…However, the barriers to greater adoption of the laparoscopic approach include longer operating time and the need for advanced laparoscopic surgical skills, including suturing. 42 The technical challenge of laparoscopic sacrocolpopexy is also suggested by Gabriel et al, 43 who concluded that the lack of endoscopic suturing skills is the cause of lengthy learning curves and long operation times.…”

Section: Resultsmentioning

confidence: 95%

Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery

Lim¹,

Ghosh²,

Niklewski³

et al. 2017

JSLS

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Background:Laparoscopic surgery is increasingly replacing the open procedure because of its many patient-related benefits that are well aligned with policies and programs that seek to optimize health system performance. However, widespread adoption of laparoscopic surgery has been slow, in part, because of the complexity of laparoscopic suturing. The objective of this study was to review the clinical and economic impacts of laparoscopic suturing in key procedures and to assess its role as a barrier to the broader adoption of laparoscopic surgery.Database:A medical literature search of MEDLINE, EMBASE, and BIOSIS from January 2010 through June 2016 identified 47 relevant articles.Conclusion:Laparoscopic suturing and intracorporeal knot tying may result in extended surgical time, complications, and surgeon errors, while improving patient quality of life through improved cosmesis, diet toleration, and better bowel movements. Despite advancement in surgical techniques and the availability of newer surgical tools, the complexity of laparoscopic suturing continues to be a barrier to greater adoption of MIS. The results of the study underscore the need for development of proficiency in laparoscopic suturing, which may help improve patient outcomes and reduce healthcare costs.

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“…However, sacrocolpopexy presents technical difficulties with a long learning curve and high risk during the procedure . Since exposing anterior longitudinal ligament is an inevitable step during the sacrocolpopexy, the procedure usually causes various certain deficiencies, including intrusion to the area of retroperitoneal nerve plexuses, the risks of vascular complications and nonphysiological placement . Thus, the technique is usually reserved for skilled operators who have prominent orientation in anatomical structures of the lesser pelvis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic inguinal ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse

Dai

Shu

2019

J of Obstet and Gynaecol

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Aim: To demonstrate the efficacy and safety of a modified technique of laparoscopic inguinal ligament suspension (LILS) with hysterectomy for the treatment of uterovaginal prolapse. Methods: A total of 57 patients were treated by LILS combined with hysterectomy between Jan 2014 and Feb 2016. The perioperative parameters, such as operative time, estimated blood loss, length of stay and intra-and postoperative complications were recorded. The Pelvic Organ Prolapse questionnaire classification was applied to evaluate the Pelvic Organ Prolapse stage, and Patient Global Impression of Improvement scale was used to determine the patients' satisfaction. Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire were used to evaluate the functional improvement. All data were collected preoperatively and then at 12 months postoperatively. Results: The mean surgical time was 130.4 (82-190) min, the average blood loss was 50.4 (10-300) mL and the mean hospitalization was 5.3 (4-8) days. The rates of intra-and postoperative complications were low. After a minimal of 12 months follow-up, the anatomical success rate was 85.5%, and the subjective satisfaction rate was 92.7%. The functional measures also presented a significant improvement with no recurrence of prolapse. Conclusion: LILS combined with hysterectomy was a safe and effective technique and might be considered as an alternative treatment for patients with uterovaginal prolapse.

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Twenty years of laparoscopic sacrocolpopexy: where are we now?

Abstract: In the future, we will need more prospective studies to compare LSC with vaginal reconstructive surgery.

Cited by 25 publications

References 13 publications

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery

Laparoscopic inguinal ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse

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