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- Title
Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial.
- Authors
Morciano, Andrea; Marzo, Giuseppe; Caliandro, Dario; Campagna, Giuseppe; Panico, Giovanni; Alcaino, Simona; Bisanti, Tatiana; Ercoli, Alfredo; Romualdi, Daniela; Scambia, Giovanni
- Abstract
<bold>Purpose: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
PELVIC organ prolapse; PELVIC organ prolapse treatment; LAPAROSCOPIC surgery; LAPAROSCOPY; VAGINAL disease treatment
- Publication
Archives of Gynecology & Obstetrics, 2018, Vol 298, Issue 5, p939
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-018-4916-0