Laparoscopic approach to pelvic organ prolapse - the way to go or a blind alley?

Malanowska, Ewelina; Šoltés, Marek; Starczewski, Andrzej; Petri, E.; Jóźwik, Marcin

doi:10.5114/wiitm.2019.88749

Cited by 3 publications

(1 citation statement)

References 39 publications

(46 reference statements)

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“…The technique is similar to the Dubuisson procedure, the recently appeared procedure, but presents specific modifications (38).…”

Section: Hysteropexy With Lateral Fixationmentioning

confidence: 99%

Surgical Treatment of Pelvic Static Disorders - General Principles and Discussions

Nitu,

Sârbu,

Savin

et al. 2023

ARS Medica Tomitana

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Introduction: Pelvic static disorders have a major impact on patients’ quality of life, constituting a real public health problem, despite the fact that they are not life-threatening. Pelvic static disorders are characterized by varying degrees of damage to the structures of the pelvic floor, which leads to the appearance of some anatomical-clinical entities, the most common of which are urinary incontinence and pelvic organ prolapse. There is no consensus regarding the optimal treatment of pelvic static disorders, reconstruction techniques being extremely numerous, from classic techniques, which use the patients’ own tissues to laparoscopic techniques and those using alloplastic materials Methods: In the Surgery Clinic I of SCJU Constanța, 89 surgical interventions for the correction of uterine prolapse and 22 interventions for the correction of vaginal vault prolapse were performed on a group of 327 patients, using both reconstructive and obliterative surgical techniques Results: The best anatomical success rate was achieved by performing laparoscopic colposuspension by the lateral suspension procedure, followed by laparoscopic sacrocolpopexy and colposuspension at the sacrospinous ligaments Conclusions: Hystero/colposuspension is a lateral fixation procedure that fulfills the four major goals of surgical prolapse cure: reduction of prolapse, absence of functional symptoms, patient satisfaction, and avoidance of complications. The technique is simple, requires a short operative time with minimal operative trauma, rapid postoperative recovery with a high degree of satisfaction in terms of quality of life and early socio-professional integration of the patients.

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“…The technique is similar to the Dubuisson procedure, the recently appeared procedure, but presents specific modifications (38).…”

Section: Hysteropexy With Lateral Fixationmentioning

confidence: 99%

Surgical Treatment of Pelvic Static Disorders - General Principles and Discussions

Nitu,

Sârbu,

Savin

et al. 2023

ARS Medica Tomitana

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Transvaginal single-port laparoscopic pelvic reconstruction with Y-shaped mesh: experiences of 93 cases

Wang

et al. 2020

Int Urogynecol J

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Robotic versus Mini-Laparoscopic Colposacropexy to Treat Pelvic Organ Prolapse: A Retrospective Observational Cohort Study and a Medicolegal Perspective

Billone,

Gullo,

Perino

et al. 2024

JCM

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Background: POP (pelvic organ prolapse) involves the descent of one or more pelvic organs downwards with or without protrusion from the vaginal opening, caused by the relaxation and weakening of ligaments, connective tissue, and pelvic muscles. Such an outcome negatively impacts the quality of life. The gold standard procedure for repairing apical compartment prolapse is colposacropexy (CS) to secure the anterior and posterior walls of the vagina to the anterior longitudinal sacral ligament, located anteriorly to the sacral promontory, using a mesh. Several surgical approaches are feasible. Laparotomic or minimally invasive methods, including laparoscopic or robotic ones, can restore the horizontal axis of the vagina and typically involve concomitant hysterectomy. Methods: This study is based on 80 patients who underwent CS at Palermo’s Ospedali Riuniti Villa Sofia-Cervello from 2019 to 2023. Women aged 35–85 at the time of surgery were divided into two groups: 40 patients underwent mini-laparoscopic surgery, and 40 patients underwent robotic surgery. The following parameters were accounted for: demographic data (initials of name and surname, age), preoperative clinical diagnosis, date of surgery, surgical procedure performed, estimated intraoperative blood loss, duration of surgical intervention, length of hospital stay, postoperative pain assessed at 24 h using the VAS scale, and any complications occurring in the postoperative period. Mini-laparoscopic CS (Minilap) and robotic CS (Rob) were then compared in terms of outcomes. Results: In the Minilap group, 11 patients out of 40 had a preoperative diagnosis of vaginal vault prolapse. The average age in this group was 61.6. Five of these patients had isolated cystocele, while the rest presented vaginal stump prolapse linked to cystocele, rectocele, or both. The remaining 29 patients in the Minilap group had a preoperative diagnosis of uterovaginal prolapse, also associated with cystocele, rectocele, or both, or isolated in nine cases. In the Rob group (average age: 60.1), 13 patients were diagnosed with vaginal prolapse (isolated or associated with cystocele), while the remaining 27 had a diagnosis of uterovaginal prolapse. In the Minilap group, the average procedure duration was 123.3 min, shorter than the Rob group (160.1 min). Conclusions: The data collected throughout this prospective study point to the mini-laparoscopic approach as being preferable over the robotic one in terms of surgical procedure length, intraoperative blood loss, postoperative pain, and aesthetic outcome. Hospital stay duration and post operative complication rates were similar for both groups. The innovative and ever-progressing nature of such procedures calls for novel standards prioritizing patient care as well as medicolegal viability.

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Laparoscopic approach to pelvic organ prolapse - the way to go or a blind alley?

Cited by 3 publications

References 39 publications

Surgical Treatment of Pelvic Static Disorders - General Principles and Discussions

Surgical Treatment of Pelvic Static Disorders - General Principles and Discussions

Transvaginal single-port laparoscopic pelvic reconstruction with Y-shaped mesh: experiences of 93 cases

Robotic versus Mini-Laparoscopic Colposacropexy to Treat Pelvic Organ Prolapse: A Retrospective Observational Cohort Study and a Medicolegal Perspective

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