Percutaneous laparoscopic harvest and trans-vaginal implantation of autologous rectus fascia in the treatment of severe anterior vaginal prolapse.

OBJECTIVE

To observe the efficacy of percutaneous laparoscopic harvest and trans-vaginal implantation of autologous rectus fascia (ARF) in the treatment of severe anterior vaginal prolapse (SAP).

MATERIALS AND

METHODS

All women who underwent percutaneous laparoscopic harvest and trans-vaginal Implantation of ARF to treat SAP between December 2022 to December 2023 at a single center. Major measurements include operation time, blood loss, postoperative hospital stay, Pelvic Floor Distress Inventory-20 (PFDI-20), patient satisfaction, Patient Global Impression of Improvement (PGI-I), Pelvic Organ Prolapse Quantification (POP-Q). All patients were followed up at 3 months, 1 year and 2 years after the surgery.

RESULTS

7 patients underwent pelvic floor repairing surgery using the described technique with an average age of 63.6 years, BMI 24.0 kg/m2, and median parity 2. The average preoperative PFDI-20 score was 67.2. The average operation duration was 163.2 min, intraoperative blood loss was 41.4 mL, and postoperative hospital stay was 4.6 days. No severe complications occurred in the perioperative period. No patients had developed recurrence of prolapse by the average 26 months postoperative telephone follow-up. The average PFDI-20 score was 12.8 and 12.2 at 12 and 24 months of follow-up, respectively. Patient satisfaction remained high and the PGI-I outcome remained "significantly improved" in all patients.

CONCLUSION

Harvesting ARF by percutaneous laparoscopy is feasible, and trans-vaginal implantation of ARF to treat SAP has good effects, high safety, and high postoperative satisfaction. More data and longer-term follow-up are needed to confirm these findings.