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Organo Oficial de la Sociedad Mexicana de Urología

2010, Number 2

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Rev Mex Urol 2010; 70 (2)

Laparoscopic sacrocolpopexy

Marquina-Sánchez M, Esquivel-Pedraza P

Language: Spanish
References: 39
Page: 71-75
PDF size: 231.43 Kb.


ABSTRACT

Sacrocolpopexy (SCP) performed as open surgery is the best definitive treatment option for vaginal prolapse, but morbidity is lower when it is performed via the vagina.
Objective: To describe the laparoscopic technique used in treating patients with this pathology.
Materials and methods: After vaginal vault dissection a polypropylene mesh was placed at the posterior vaginal wall and another at the anterior vaginal wall. They were then joined together and attached to the sacral promontory with non-absorbable suture. The mesh was covered with the posterior parietal peritoneum. Conversion to open surgery, urinary incontinence, patient satisfaction and morbidity were analyzed and there was a minimum oneyear follow-up.
Results: From June 2005 to February 2007 four laparoscopic sacrocolpexies (LSCP) for vaginal prolapse were performed. Of the four patients, two had a medical history of hysterectomy, one underwent hysterectomy during LSCP (because of large myomas accompanied with hypermenorrhea) and one had no hysterectomy indication. Mean follow-up was 26 months, mean age was 60 years and mean surgery duration was 142 min. All patients were released the day after surgery. There were no cases of vaginal prolapse recurrence. One patient required the placement of a sling because she developed stress urinary incontinence after LSCP. Another patient developed hernia at one of the port sites that was repaired one year after LSCP with no complications. All four patients are satisfied with the results of their vaginal prolapse repair.
Conclusions: Laparoscopic sacrocolpopexy is considered to be a minimally invasive technique for vaginal prolapse repair and combines the advantages of open sacrocolpopexy with the lower morbidity of laparoscopy.


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