Journal of minimally invasive gynecology · 2019
Short-term Outcomes of Non-robotic Single-incision Laparoscopic Sacrocolpopexy: A Surgical Technique.
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Liu Juan, Kohn Jaden, Wu Chunhua, Guan Zhenkun, Guan Xiaoming
Аннотация
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 single-incision 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 -2.6 ± 0.5 cm for the Aa point and 3.2 ± 2.8 cm versus -4.6 ± 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.
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 single-incision 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 -2.6 ± 0.5 cm for the Aa point and 3.2 ± 2.8 cm versus -4.6 ± 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.
Предметные рубрики MeSH
AdultAgedAged, 80 and overChinaColposcopyFemaleHumansLaparoscopyMiddle AgedOperative TimePelvic FloorPelvic Organ ProlapsePostoperative ComplicationsQuality of LifeRetrospective StudiesSacrococcygeal RegionSurgical MeshSurgical WoundSurveys and QuestionnairesTime FactorsTreatment OutcomeUrinary Incontinence, Stress