Wagner L, Boileau L, Delmas V, Haab F, Costa P
Service d'Urologie, Hôpital Carémeau, CHU de Nîmes, Université Montpellier-I, Place du Pr-R-Debré, 30029 Nîmes cedex 9, France.
Prog Urol. 2009 Dec;19(13):994-1005. doi: 10.1016/j.purol.2009.09.026. Epub 2009 Oct 21.
The laparoscopic sacrocolpopexy is the preferred procedure for the young woman. The procedure is that used for pelvic laparoscopy. The steps are identical as during open sacrocolpopexy, with the advantages of pneumodissection and better vision. The success rate is more than 90% and redux is mostly cystocele. Mesh erosion is reported in 2,7 to 9%. The indication for a posterior mesh is recommended if there is a rectocele or if a colposuspension at the same time. The fixation of the mesh must be posteriorly on the central tendon of perineum and the levator ani with a non resorbable stitches. The best mesh is type I in Amid classification. The comparative studies with open sacrocolpopexy and sacrospinifixation show an advantage for pain and hospital stay, but greater operative time for identical results. In preliminary results, the robotic abdominal sacrocolpopexy give the same results with a greater cost.
腹腔镜骶骨阴道固定术是年轻女性的首选手术方法。该手术用于盆腔腹腔镜检查。其步骤与开放性骶骨阴道固定术相同，具有气腹解剖和视野更好的优点。成功率超过90%，复发主要是膀胱膨出。网片侵蚀的报告发生率为2.7%至9%。如果存在直肠膨出或同时进行阴道悬吊术，则建议使用后路网片。网片必须用不可吸收缝线固定在会阴中心腱和肛提肌后方。在阿米德分类中，最佳网片为I型。与开放性骶骨阴道固定术和骶棘肌固定术的比较研究表明，在疼痛和住院时间方面具有优势，但为获得相同结果手术时间更长。初步结果显示，机器人辅助腹部骶骨阴道固定术成本更高但结果相同。
