Minilaparoscopic Versus Conventional Laparoscopic Sacrocolpopexy: A Comparative Study

Abstract

Introduction and Aims: We aim to compare clinical and surgical outcomes between minilaparoscopic sacrocolpopexy (MLSC) and conventional laparoscopic sacrocolpopexy (LSC). As far as we know, no comparative study exists between these two minimal invasive procedures to correct vaginal prolapse. Design and Setting: An observational and comparative study with 20 individuals submitted to vaginal vault prolapse correction between June and December of 2014 in our tertiary referral unit. Nine women were submitted to 3-mm MLSC and the others were approached by a standard 5-mm laparoscopic technique. Materials and Methods: Women's demographic data and prolapse grade were evaluated preoperatively using the Pelvic Organ Prolapse Quantification score. Operative parameters (surgical time, blood loss, and complications under Satava and Clavien-Dindo classification) and length of hospitalization were also compared. Postoperative pain and surgical scar satisfaction were measured using Visual Analog Pain Scale and Patient and Observer Scar Assessment Questionnaire, respectively. Results: MLSC took approximately the same time as LSC (P > .05). No significant differences in operative time, blood loss, length of hospitalization, and complications (Satava, Clavien-Dindo) were observed between both groups. Pain score after surgery was similar in MLSC and LSC (P > .05). Surgical scar monitoring at 3 months established that MLSC produced better overall results than LSC (P < .05). Anatomic cure rate was 100%. Conclusion: Minilaparoscopy is a feasible and attractive approach for sacrocolpopexy as it enhances cosmetics, keeping the low morbidity associated with the classical laparoscopic approaches.

Neovagina creation in congenital vaginal agenesis: New mini-laparoscopic approach applying intraoperative indocyanine green fluorescence

“…These advantages are even more evident with the use of mini-laparoscopic instruments whose manipulation requires a delicate surgical technique and even more precise surgical dissection, resulting in less postoperative pain and also better aesthetic results. 30,31 Benefits of mini-laparoscopy are already reported, including an enhanced cosmetic outcome and less tissue trauma, which may decrease postoperative pain without additional operative time or complications. 30,31 Higher aesthetic satisfaction with scars after mini-laparoscopy has been pointed as a key benefit of this approach, since it is consistently found in a variety of surgical procedures for gynecology, general surgery, pediatrics, and urology.…”

“…30,31 Benefits of mini-laparoscopy are already reported, including an enhanced cosmetic outcome and less tissue trauma, which may decrease postoperative pain without additional operative time or complications. 30,31 Higher aesthetic satisfaction with scars after mini-laparoscopy has been pointed as a key benefit of this approach, since it is consistently found in a variety of surgical procedures for gynecology, general surgery, pediatrics, and urology. [31][32][33][34] Therefore, the mini-laparoscopic approach shows important benefits in this specific population, since we are treating young women, whose cosmetic results often have a significant impact on patient satisfaction and self-esteem.…”

“…30,31 Higher aesthetic satisfaction with scars after mini-laparoscopy has been pointed as a key benefit of this approach, since it is consistently found in a variety of surgical procedures for gynecology, general surgery, pediatrics, and urology. [31][32][33][34] Therefore, the mini-laparoscopic approach shows important benefits in this specific population, since we are treating young women, whose cosmetic results often have a significant impact on patient satisfaction and self-esteem. Moreover, it is also adequate for this specific procedure, since it is a relatively simple technique with no complex dissection, perfectly adapted for 3-mm trocars, providing better aesthetic results while keeping the low morbidity associated with the classical laparoscopic approaches.…”

“…[24][25][26][27][28][29] Mini-laparoscopy, with 5-mm optics and 3-mm trocars, is a recent and growing surgical option in gynecology with recent studies reporting its utility and feasibility in a variety of gynecological procedures with several validated benefits. [30][31][32][33][34] Additionally, indocyanine green (ICG) is a fluorescent dye with a well-documented safety profile that is particularly useful for fluorescence-guided surgery because its excitation peak and emission peak are in near infrared (NIR). 35,36 Its applications are evolving in many fields of medicine and surgery, including lymphography and sentinel lymph node mapping in oncologic surgery, along with angiography and tissue perfusion evaluation in gynecologic, urologic, digestive, and reconstructive surgery to evaluate the viability of tissues and to assess possible anastomoses sites or anastomotic leaks.…”

Disturbed Interstitial Pregnancy: A First Case of Successful Treatment Using a Mini-Laparoscopic Approach

“…The interventions for treatment and determination of the stage of cancer of the endometrium (2009) [12], as well as of cancer of the uterine cervix (2011) [7,13,14], were also subsequently minimized. The method is applied for sacrocolpopexy with utero-vaginal and apical prolapse [15]. In a scientific report from 2015, the authors successfully demonstrated a mini-laparoscopic approach adopted for the removal of enlarged myomatous uteri at more than 16 gestational weeks [16].…”