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

Giovanni Scambia, Alfredo Ercoli, Daniela Romualdi, Andrea Morciano, Giuseppe Marzo, Dario Caliandro, Simona Alcaino, Tatiana Bisanti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

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.
Lingua originaleEnglish
pagine (da-a)939-944
Numero di pagine6
RivistaArchives of Gynecology and Obstetrics
Volume298
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Continuous suture
  • Laparoscopy
  • Mesh fixation
  • Obstetrics and Gynecology
  • Pelvic organ prolapse
  • Running suture
  • Sacral colpopexy

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