Expanding minimally invasive horizons for pubic symphysis diastasis: The laparoscopic total extraperitoneal approach in orthopedic surgery (O-TEP).

BACKGROUND

This study aims to present the preliminary clinical and functional outcomes of pubic symphysis diastasis (PSD) cases treated with plate-screw fixation using the laparoscopic total extraperitoneal approach in orthopedic surgery (O-TEP).

METHODS

This retrospective study included 13 patients who underwent O-TEP symphysis pubis plating for PSD between March 2022 and May 2025, all with a minimum follow-up period of 12 months. Data collected encompassed demographic characteristics, injury mechanisms, additional pathologies, and injury classifications (Young-Burgess and AO/OTA). Surgical details, including duration, blood loss, hospital stay, and postoperative follow-up, were recorded. Clinical and functional outcomes were assessed using postop-erative VAS scores, as well as Iowa Pelvic and Majeed Pelvic scores at the final follow-up. The study also evaluated implant failure, the need for revision surgery, and surgery-related complications.

RESULTS

The mean age of the patients was 40±14.8 years (21-61). The gender distribution was 77% male and 23% female. The mean operating time was 113±36 minutes (65-175). The average blood loss was 127±67.3 ml (70-300), and the mean postoperative hospitalization period was 2.7±0.8 days (2-4). No postoperative complications, such as infection, implant failure, loss of reduction, or need for revision, were observed. Postoperative VAS scores on days 1 and 2 were 3.7±1.5 (1-6) and 2.2±1.03 (1-4), respectively. The mean follow-up period was 21.5±6.9 months (12-32), with a mean Iowa Pelvic Score of 87.1±4.7 (80-95) and a mean Majeed score of 84.9±4.01 (78-91).

CONCLUSION

Laparoscopic total extraperitoneal approach in orthopedic surgery (O-TEP) is an innovative minimally invasive technique that expands the available options for surgeons in the treatment of selected anterior pelvic ring injuries, providing clinically and radiologically satisfactory outcomes.