Purpose: Laparoscopic sacral colpopexy (LSC) plus supracervical hysterectomy (LSH) for pelvic organ prolapse (POP) is a high-complexity surgical procedure. The aim of the present study was to evaluate a new approach to vaginal-mesh fixation during LSC with continuous locked suture. Methods: This is a prospective randomized double-blinded clinical trial enrolling 90 patients with severe POP from January 2016 to April 2017. Patients underwent LSH plus a “two-meshes” LSC and were randomized, regarding mesh fixation, in Group 1 (extracorporeal interrupted 3-0 delayed absorbable sutures) and Group 2 (running locked 3-0 delayed absorbable suture). Our primary endpoints were the operative times and the secondary endpoints the incidence of intra- or post-operative complications. Results: A total of 42 patients for group completed the study. Baseline characteristics were similar between the groups. Overall mesh fixation time (24 vs. 39 min; p < 0.01), and operative time (121 vs. 138 min; p < 0.05) resulted significantly lower in Group 2. No differences were found in terms of anatomic failure, vaginal mesh erosion or intra- or post-operative complications. Conclusions: Laparoscopic continuous locked 3-0 absorbable suture for anterior and posterior mesh fixation during LSC guaranteed a faster and effective alternative to multiple interrupted sutures. The significant operative time reduction linked to this technique should be considered even more helpful when performing a highly complex surgery such as LSC.

Morciano, A., Marzo, G., Caliandro, D., Campagna, G., Panico, G., Alcaino, S., Bisanti, T., Ercoli, A., Romualdi, D., Scambia, G., Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial, <<ARCHIVES OF GYNECOLOGY AND OBSTETRICS>>, 2018; 298 (5): 939-944. [doi:10.1007/s00404-018-4916-0] [http://hdl.handle.net/10807/135037]

Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial

Ercoli, Alfredo;Romualdi, Daniela;Scambia, Giovanni
2018

Abstract

Purpose: Laparoscopic sacral colpopexy (LSC) plus supracervical hysterectomy (LSH) for pelvic organ prolapse (POP) is a high-complexity surgical procedure. The aim of the present study was to evaluate a new approach to vaginal-mesh fixation during LSC with continuous locked suture. Methods: This is a prospective randomized double-blinded clinical trial enrolling 90 patients with severe POP from January 2016 to April 2017. Patients underwent LSH plus a “two-meshes” LSC and were randomized, regarding mesh fixation, in Group 1 (extracorporeal interrupted 3-0 delayed absorbable sutures) and Group 2 (running locked 3-0 delayed absorbable suture). Our primary endpoints were the operative times and the secondary endpoints the incidence of intra- or post-operative complications. Results: A total of 42 patients for group completed the study. Baseline characteristics were similar between the groups. Overall mesh fixation time (24 vs. 39 min; p < 0.01), and operative time (121 vs. 138 min; p < 0.05) resulted significantly lower in Group 2. No differences were found in terms of anatomic failure, vaginal mesh erosion or intra- or post-operative complications. Conclusions: Laparoscopic continuous locked 3-0 absorbable suture for anterior and posterior mesh fixation during LSC guaranteed a faster and effective alternative to multiple interrupted sutures. The significant operative time reduction linked to this technique should be considered even more helpful when performing a highly complex surgery such as LSC.
2018
Inglese
Morciano, A., Marzo, G., Caliandro, D., Campagna, G., Panico, G., Alcaino, S., Bisanti, T., Ercoli, A., Romualdi, D., Scambia, G., Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial, <<ARCHIVES OF GYNECOLOGY AND OBSTETRICS>>, 2018; 298 (5): 939-944. [doi:10.1007/s00404-018-4916-0] [http://hdl.handle.net/10807/135037]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/135037
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