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Rejection of stapled prosthetic mesh after laparoscopic sacropexy
M Cosson1, D Vinatier, R Rajabally
1Maternité Jeanne de Flandres, CHRU Lille, Université Lille II, France.
Abstract:
We report the first case of rejection of prosthetic mesh after laparoscopic sacropexy using a Roticulator stapler. The risk of this complication is extremely low if simple precautions are observed. Our experience suggests that the use of staples to attach the mesh to the vaginal apex should be avoided. At the end of the procedure a careful assessment should be made to ensure that the vaginal wall is intact and not penetrated by staples.
Insights
Prosthetic mesh rejection after laparoscopic sacropexy is rare but can occur. Avoid staples attaching mesh to the vaginal apex to prevent this complication.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
Background:
- Laparoscopic sacropexy is a surgical procedure to treat pelvic organ prolapse.
- Prosthetic mesh is commonly used to support pelvic organs during sacropexy.
Observation:
- This report details the first known case of prosthetic mesh rejection following laparoscopic sacropexy.
- The complication occurred after using a Roticulator stapler to secure the mesh.
Findings:
- The risk of mesh rejection is very low with appropriate precautions.
- Staple fixation of mesh to the vaginal apex should be avoided.
- Post-procedure assessment is crucial to ensure vaginal wall integrity and absence of staple penetration.
Implications:
- Surgical techniques for laparoscopic sacropexy should prioritize mesh fixation methods that minimize complication risks.
- Avoiding staple use at the vaginal apex may prevent mesh rejection and related morbidity.
- Enhanced vigilance during and after surgery can improve patient outcomes in pelvic reconstructive procedures.