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Simplified laparoscopic sacropexy avoiding deep vaginal dissection.

Stefano Cosma1, Paolo Petruzzelli1, Michela Chiadò Fiorio Tin1

  • 1Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|August 5, 2018
PubMed
Summary

A simplified laparoscopic sacropexy effectively treats apical prolapse by anchoring mesh only to the vaginal apex. This technique improved patient outcomes and reduced operative time and adverse events.

Keywords:
Laparoscopic colposacropexyLaparoscopic sacral colpopexyLaparoscopic sacrocolpopexyLaparoscopic sacropexyLevator ani musclePelvic organ prolapsePromontofixationVaginal vault prolapse

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Area of Science:

  • Urogynecology
  • Minimally Invasive Surgery
  • Pelvic Floor Disorders

Background:

  • Pelvic organ prolapse (POP) affects many women, often requiring surgical intervention.
  • Traditional sacropexy techniques can be complex and carry risks associated with extensive dissection.
  • A simplified approach may offer a safer and more efficient alternative.

Purpose of the Study:

  • To evaluate the safety and efficacy of a simplified laparoscopic sacropexy technique.
  • To assess outcomes in women with apical prolapse, including those with multi-compartment involvement.
  • To compare this approach to traditional methods regarding operative time and adverse events.

Main Methods:

  • Retrospective analysis of 121 women with POP-Q stage 2 or higher undergoing simplified laparoscopic sacropexy.
  • Mesh anchored solely to the vaginal apex.
  • Data collected on prolapse stage, urogenital function, and quality of life preoperatively and postoperatively.

Main Results:

  • Mean follow-up of 33.2 months.
  • Low rates of recurrence (0.8%) and vaginal erosion (1.7%).
  • Significant improvements in urogenital symptom scores and quality of life scores (P<0.05).

Conclusions:

  • Simplified laparoscopic sacropexy, anchoring mesh only to the apex, is sufficient for correcting multi-compartment prolapse.
  • The technique is efficacious, time-saving, and reduces risks associated with deep vaginal dissection.
  • This approach offers a favorable safety and efficacy profile for treating apical prolapse.