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Simplified laparoscopic sacropexy avoiding deep vaginal dissection
Author(s) -
Cosma Stefano,
Petruzzelli Paolo,
Chiadò Fiorio Tin Michela,
Parisi Silvia,
Olearo Elena,
Fassio Federica,
Zizzo Roberto,
Danese Saverio,
Benedetto Chiara
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12632
Subject(s) - medicine , dissection (medical) , surgery , trigone of urinary bladder , stage (stratigraphy) , genitourinary system , laparoscopy , urinary bladder , paleontology , biology
Objective To evaluate the safety and efficacy of a “simplified ” laparoscopic sacropexy approach. Methods Data were retrospectively assessed from women with apical prolapse of stage 2 or higher who underwent “simplified” laparoscopic sacropexy between October 1, 2010, and May 31, 2017 at the St Anna Hospital, City of Health and Science, Torino, Italy. Patients were treated with the “simplified” laparoscopic sacropexy, where meshes were anchored solely to the vaginal apex, even in the presence of advanced multi‐compartment vaginal prolapse. Data on prolapse stage and urogenital functions collected through clinical examinations, and questionnaires at baseline, 6 months, 12 months, and annually thereafter were examined. Results Overall, 121 women were included in the analysis; the mean follow‐up was 33.2 months. Mean operative time was 135.1 minutes; there were no intraoperative visceral or vascular injuries. There was 1 (0.8%) patient who experienced recurrence, and 2 (1.7%) who experienced vaginal erosion. Both urogenital symptom scores (all P <0.05) and quality of life scores (all P <0.05) improved significantly. Conclusion Adequate re‐suspension of only the apex was sufficient to correct other vaginal compartments, even for women with preoperative multi‐compartment prolapse higher than POP ‐Q stage 2. The “simplified” laparoscopic sacropexy was an efficacious intraoperative time‐saving technique; it could reduce adverse events caused by deep vaginal dissection up to puborectal muscles and the bladder trigone.