Laparoscopic sacrocolpopexy with deep attachment of anterior and posterior mesh

Sarlos, Dimitri; Aigmueller, Thomas; Габриэль, С. А.

doi:10.1007/s00192-014-2436-4

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…In uterus‐sparing sacrocolpopexy, posterior mesh placement might be challenging. Posterior mesh placement may result in prolonged operation time, more pain, longer recovery time of gastrointestinal motility, and increased risk of mesh‐related complications 11,12 . Surgeons may prefer to perform sacrohysteropexy in different ways, with some attaching the mesh to both dissection areas (anterior and posterior), or to avoid the risks mentioned above, others place the mesh to the level of the trigon in the anterior (only) dissection area.…”

Section: Discussionmentioning

confidence: 99%

“…Posterior mesh placement may result in prolonged operation time, more pain, longer recovery time of gastrointestinal motility, and increased risk of mesh-related complications. 11,12 Surgeons may prefer to perform sacrohysteropexy in different ways, with some attaching the mesh to both dissection areas (anterior and posterior), or to avoid the risks mentioned above, others place the mesh to the level of the trigon in the anterior (only) dissection area. The different approaches for the management of apical prolapse are neither standardized nor assessed by prospective randomized controlled trials and meta-analyses.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, some surgeons do not perform a mesh insertion to the rectouterine space and complete the surgery with a single mesh insertion only in the vesicouterine space at the time of sacrohysteropexy, especially in patients with asymptomatic minimal rectoceles. 11,12 Comparing the anatomic outcomes, rates of success/failure, complications, and technical aspects of the surgical approaches are useful for surgeons' clinical decision-making. To the best of our knowledge, studies and data evaluating the outcomes of sacrohysteropexy surgery without posterior mesh placement are lacking and inadequate.…”

Section: F I G U R Ementioning

confidence: 99%

“…13 Anterior and posterior mesh insertion was defined as mesh placement to vesicouterine and rectouterine dissection spaces (Figure 1). 12 2.2 | Surgical technique…”

Section: Failure Criteriamentioning

confidence: 99%

“…Compared to vaginal vault prolapse, placement of the mesh in the posterior space can be quite challenging in uterus‐preserving sacrohysteropexy, which is why some surgeons prefer to perform a hysterectomy to place the mesh in the posterior space, which may cause additional surgical morbidity. On the other hand, some surgeons do not perform a mesh insertion to the rectouterine space and complete the surgery with a single mesh insertion only in the vesicouterine space at the time of sacrohysteropexy, especially in patients with asymptomatic minimal rectoceles 11,12 …”

Section: Introductionmentioning

confidence: 99%

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Anatomic outcomes of sacrohysteropexy without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles: Is a rectouterine mesh really necessary?

Sancı

Obaid

Topçuoğlu

et al. 2023

LUTS

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Objectives: To present the anatomic outcomes of sacrohysteropexy surgery without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles. Methods:The patients who underwent abdominal sacrohysteropexy without posterior mesh placement for the treatment of symptomatic grade 3 and 4 anterior/apical prolapse + asymptomatic grade 1 and 2 rectocele between May 2015 and January 2021 were evaluated retrospectively. The success rate, the anatomic outcomes (for anterior, apical, and posterior pelvic organ prolapse [POP]), and perioperative data of the surgical procedure were assessed. The objective failure criteria after surgery included the presence of grade 1 or higher in any compartment (anatomical criteria), recurrent POP requiring an operation, and/or usage of pessaries. Perioperative adverse events were categorized according to the Clavien-Dindo classification.Results: Fifty-one patients underwent sacrohysteropexy without posterior mesh. The mean age of the patients was 56.8 ± 10 years. The success rates (anatomical outcomes) for the anterior/apical and posterior POP in the study group were 60.7%, 54.9%, and 58.8%, respectively, at a median follow-up time of 40.24 (24-71) months.The median hospital stay was 3.1 (2-6) days. The mean estimated blood loss was 127.6 (80-150) mL. The mean operation time was 114 (90-156) min. The mean urethral and catheter removal times were 1.3 (1, 2) and 2.1 (2-4) days, respectively. The mean recovery time of gastrointestinal motility was 14.4 h (11-35).Conclusions: Sacrohysteropexy without posterior mesh placement might be associated with less pain, shorter operative time, and shorter recovery time of gastrointestinal motility, without compromising the anatomic success.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

“…13 Anterior and posterior mesh insertion was defined as mesh placement to vesicouterine and rectouterine dissection spaces (Figure 1). 12 2.2 | Surgical technique…”

Section: Failure Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Anatomic outcomes of sacrohysteropexy without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles: Is a rectouterine mesh really necessary?

Sancı

Obaid

Topçuoğlu

et al. 2023

LUTS

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Variation in the practice of laparoscopic sacrohysteropexy and laparoscopic sacrocolpopexy for the treatment of pelvic organ prolapse: a Dutch survey

et al. 2014

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There is a high practice variation in LSH and LSC performed by a selected group of Dutch gynecologists. Different methods have been described in the literature and there is no consensus on how to perform these procedures. A well-designed prospective study or randomized controlled trial with regard to the specific parts of these procedures is needed to provide evidence for the best surgical technique. The outcomes of these studies will help to establish evidence-based guidelines.

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Does laparoscopic sacrocolpopexy support the posterior compartment in women with multicompartment prolapse including rectocele?

Aichner,

Studer,

Frey

et al. 2024

Preprint

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Purpose This study aimed to evaluate the effectiveness of nerve-sparing laparoscopic sacrocolpopexy in managing multicompartment prolapse with concurrent rectocele (≥ stage II). It sought to determine if additional posterior repair was necessary for successful support of the posterior compartment and to evaluate the impact on bowel function in women undergoing surgery. Methods Data from all women who underwent laparoscopic sacrocolpopexy with or without posterior repair between 01/2017 and 07/2022 for symptomatic multicompartment prolapse, including apical and posterior compartment descent ≥ stage II, were retrospectively evaluated. All women underwent a urogynecological examination, including assessment of genital prolapse using the POP-Q quantification system and completed the validated German Female Pelvic Floor questionnaire pre- and postoperatively (6-12 weeks). Preoperative anatomic support and bowel symptoms were compared to postoperative values. Results In total 112 women met the criteria for surgical correction. The majority (87%) had stage II posterior descent, with only 10% undergoing concurrent posterior repair during laparoscopic sacrocolpopexy. Significant (p<0.001) objective improvement was seen for all compartments post- compared to preoperatively (Ba: 0(-1/2) vs -3(-3/-2), C: -1(-2/0) vs -8(-12/-7), Bp:0(-1/0) vs -3(-2/-2); (Median 25%/75% quartiles)). Subsequent surgery for persistent rectocele and/or stool outlet symptoms was required in 4% of cases. Most bowel specific questions in the German Female Pelvic Floor Questionnaire showed significant improvement (p<0.001). Conclusion Nerve-sparing sacrocolopopexy alone seems to be a suitable surgical approach correcting multicompartment prolapse, including a rectocele ≥ stage II and results in a reduction of objective signs and symptoms of pelvic organ prolapse.

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Laparoscopic sacrocolpopexy with deep attachment of anterior and posterior mesh

Abstract: The video shows that deep mesh placement is feasible and can be performed with standardized parameters. The technique is based on 12 years of experience with laparoscopic sacrocolpopexy; 1- and 5-year results, published in this journal, show it is safe and provides good long-term results.

Cited by 5 publications

References 2 publications

Anatomic outcomes of sacrohysteropexy without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles: Is a rectouterine mesh really necessary?

Anatomic outcomes of sacrohysteropexy without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles: Is a rectouterine mesh really necessary?

Variation in the practice of laparoscopic sacrohysteropexy and laparoscopic sacrocolpopexy for the treatment of pelvic organ prolapse: a Dutch survey

Does laparoscopic sacrocolpopexy support the posterior compartment in women with multicompartment prolapse including rectocele?

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