Laparoscopic Approach for Shull Repair of Pelvic Floor Defects

Restaino, Stefano; Ronsini, Carlo; Finelli, Angelo; Santarelli, Alessandro; Scambia, Giovanni; Fanfani, Francesco

doi:10.1016/j.jmig.2017.12.016

Cited by 16 publications

(10 citation statements)

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“…Total hysterectomy is a widespread procedure and minimally invasive approaches are becoming the preferred route [ 23 , 24 ]. The advantages are a less invasive procedure, leading to a reduction in intra and postoperative complications, such as fewer bleedings, fewer port related injuries, decrement in postoperative pain, and faster recovery [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic Single-Site Hysterectomy in Gynecologic Benign Pathology: A Systematic Review of the Literature

et al. 2023

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Background and objectives: Total hysterectomy is one of the most common gynecologic surgical procedures and it is mainly performed for benign pathologies. The introduction of robotic single-site surgery (RSS) as an acceptable alternative to laparoendoscopic surgery combines the advantages of robotics with the aesthetic result of a single incision. This study aims to review the existing literature on a single-site robotic hysterectomy in patients with benign pathologies and verify its safety and feasibility. Materials and Methods: Following the recommendations in the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, FP and AR systematically screened the PubMed, Embase, and Scopus databases. No temporal or geographical limitation was discriminatory. Studies containing data about feasibility and safety were included. Results: From 219, only eight studies met the inclusion criteria, and a total of 212 patients were included with a mean patient age of 45.42 years old (range 28–49.5 years old) and a mean BMI of 25.74 kg/m2 (range 22–28.5 kg/m2). The mean presurgical time, including port placement and docking time, was 15.56 (range 3–30) minutes. Mean console time was reported in six studies and is 83.21 min (range 25–180 min). The mean operative time is 136.6 min (range 60–294 min) and the mean blood loss is 43.68 mL (range 15–300 mL). Only two patients in the total analyzed had intraoperative complications and no conversion to LPT occurred. The median hospital stay was 1.71 days (range 0.96–3.5 days). The postoperative complication rate was estimated at 1.4% (vaginal bleeding). Conclusions: Our review supports the safety and feasibility of robotic single-site hysterectomy for benign gynecological diseases.

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Section: Discussionmentioning

confidence: 99%

Robotic Single-Site Hysterectomy in Gynecologic Benign Pathology: A Systematic Review of the Literature

et al. 2023

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“…Since the US Food and Drug Administration (FDA) stopped the distribution of transvaginal meshes, native tissue repair surgeries have been re-evaluated. Shull's technique of uterosacral ligament suspension (USLS) provides a safe and effective approach for apical prolapse without prosthetic materials ( 19 ). However, USLS resulted in a higher prolapse recurrence rate than sacrocolpopexy for stage III prolapse ( 20 ), and the risk of ureteral obstruction could not be totally avoided even if intraoperative cystoscopy was performed ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Strengthen the sacral ligament and paravagina by equilibrium control severe pelvic organ prolapse

Zhao

Niu

2023

Front. Surg.

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ObjectiveTo evaluate and analyze the clinical effect of the combination of laparoscopic sacrocolpopexy (LSC), sacral ligament fusion and vaginal suspension in the treatment of severe pelvic organ prolapseMethodsA total of 76 cases of patients with pelvic organ prolapse in our hospital between January 2010 to December 2020 were enrolled for research. They had been evaluated pre- and post-operative through pelvic organ prolapse quantification (POP-Q) system, Pelvic Floor Dysfunction Questionnaire Short Form (PFDI-20), Pelvic Floor Function Impact Questionnaire Short form (PFIQ-7), and the Sexual Function Questionnaire Score (PIQS-31).ResultsAll 76 patients went through the procedure successfully without any complications. None of the 76 cases had relapsed. Post-operational results of PFDI-20 and PFIQ-7 were evidently lower than pre-operational results, post-operational results of PIQS-31 were higher than before operation.ConclusionsFor patients with severe pelvic organ prolapse,a balanced control of the pelvic floor centred on the preservation of the stereoscopic ring around the cervix through revascularization is significantly effective, and has no recurrence after surgery, high patient satisfaction, fewer postoperative complications. It is safe and reliable and worthy of clinical application and promotion.

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“…At present, NOTES, including laparoendoscopic single-site surgery (LESS) and transvaginal natural orifice transluminal endoscopic surgery (vNOTES), is widely performed. Laparoscopic treatment includes uterine round ligament suspension, uterosacral ligament shortening, uterosacral ligament suspension ( 17 ), sacrospinous ligament fixation (SSLF), laparoscopic sacral colpopexy (LSCP) and pubic bone fixation. These surgical procedures shift from removing the bulging tissues and organs to strengthening the pelvic floor structure, thus maintaining the integrity of the pelvic floor support structure, with the advantages of rapid postoperative recovery and minimal trauma.…”

Section: Discussionmentioning

confidence: 99%

Case report: Transvaginal single-port extraperitoneal laparoscopic sacrospinous ligament fixation for apical prolapse: A single-center case series

Liu

Wang

et al. 2023

Front. Surg.

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BackgroundSacrospinous ligament fixation (SSLF) is a minimally invasive and effective procedure for the treatment of apical prolapse. Because intraoperative exposure of the sacrospinous ligament is difficult, SSLF is difficult. The aim of our article is to determine the safety and feasibility of single-port extraperitoneal laparoscopic SSLF for apical prolapse.MethodsThis single-center, single-surgeon case series study included 9 patients with pelvic organ prolapse quantification (POP-Q) III or IV apical prolapse who underwent single-port laparoscopic SSLF. Additionally, transobturator tension-free vaginal tap (TVT-O) was performed in 2 patients, and anterior pelvic mesh reconstruction was performed in 1 patient.ResultsThe operative time ranged from 75 to 105 (mean, 88.9 ± 10.2) min, and blood loss ranged from 25 to 100 (mean, 43.3 ± 22.6) ml. No serious operative complications, blood transfusions, visceral injuries, or postoperative gluteal pain were reported for these patients. After 2–4 months of follow-up, no recurrence of POP, gluteal pain, urinary retention/incontinence, or other complications was observed.ConclusionTransvaginal single-port SSLF is a safe, effective, and easy-to-master operation for apical prolapse.

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Laparoscopic Approach for Shull Repair of Pelvic Floor Defects

Abstract: The Shull laparoscopic surgery for advance POP with reconstruction of the anterior compartment is technically feasible.

Cited by 16 publications

References 0 publications

Robotic Single-Site Hysterectomy in Gynecologic Benign Pathology: A Systematic Review of the Literature

Robotic Single-Site Hysterectomy in Gynecologic Benign Pathology: A Systematic Review of the Literature

Strengthen the sacral ligament and paravagina by equilibrium control severe pelvic organ prolapse

Case report: Transvaginal single-port extraperitoneal laparoscopic sacrospinous ligament fixation for apical prolapse: A single-center case series

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