Kallidonis Panagiotis, Al-Aown Abdulrahman, Vasilas Marinos, Kyriazis Iason, Panagopoulos Vasilis, Fligou Fotini, Athanasopoulos Anastasios, Fariborz Bagheri, Liatsikos Evangelos, Özsoy Mehmet
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, Armed Forces Hospital Southern Region, Khamis Mushait, Kingdom of Saudi Arabia.
Urol Ann. 2017 Apr-Jun;9(2):159-165. doi: 10.4103/UA.UA_161_16.
Laparoscopic sacrocolpopexy (LSC) has established itself as a safe method for the management of pelvic organ prolapse (POP). Laparoscopic suturing is a time-consuming intraoperative task during LSC. Self-retaining barbed sutures (SBSs) are known to reduce the operative time in laparoscopic cases. The current study aimed to evaluate the efficacy and safety of SBS during the performance of LSC.
Twenty female patients with symptomatic POP were treated with LSC by an expert surgeon. The preoperative evaluation included the International Continence Society POP-quantification (POP-Q) and the prolapse-specific quality-of-life questionnaire Mesh fixation was performed with SBS anteriorly on the anterior vaginal wall and posteriorly on the levator ani muscle. A 5-mm titanium tacking device was used for promontofixation. The peritoneum was also closed with an SBS.
Mean patient's age was 63 years (range: 50-79 years). According to POP-Q, system 3 patients (15%) had Stage I, 12 patients (60%) had Stage II, 3 patients (15%) had Stage III, and 2 patients (10%) had Stage IV prolapse. Concomitant hysterectomy was performed in 14 patients, respectively. Mean operative time was 99.75 (range: 65-140) min, mean blood loss was 57.75 (range: 30-120) ml. One patient had a bladder perforation intraoperatively, and three patients developed transient fever postoperatively. One patient had a recurrent cystocele and three patients recurrent rectocele.
The current study renders the use of SBS during LSC to be safe and efficient. Further comparative studies would elucidate the impact of the use of SBS in LSC.
腹腔镜骶骨阴道固定术（LSC）已成为治疗盆腔器官脱垂（POP）的一种安全方法。在LSC手术中，腹腔镜缝合是一项耗时的术中操作。自固定倒刺缝线（SBSs）已知可减少腹腔镜手术的手术时间。本研究旨在评估LSC手术中SBS的有效性和安全性。
20例有症状的POP女性患者由一名专家外科医生进行LSC治疗。术前评估包括国际尿控协会POP量化（POP-Q）和脱垂特异性生活质量问卷。使用SBS在前阴道壁前方和肛提肌后方进行网片固定。使用5毫米钛钉固定装置进行骶岬固定。腹膜也用SBS缝合。
患者平均年龄为63岁（范围：50 - 79岁）。根据POP-Q，3例患者（15%）为I期，12例患者（60%）为II期，3例患者（15%）为III期，2例患者（10%）为IV期脱垂。分别有14例患者同时进行了子宫切除术。平均手术时间为99.75（范围：65 - 140）分钟，平均失血量为57.75（范围：30 - 120）毫升。1例患者术中膀胱穿孔，3例患者术后出现短暂发热。1例患者出现复发性膀胱膨出，3例患者出现复发性直肠膨出。
本研究表明在LSC手术中使用SBS是安全有效的。进一步的比较研究将阐明SBS在LSC手术中的应用影响。
