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腹腔镜盆底固定术:单中心采用新技术治疗顶端脱垂手术的初步经验

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery.

作者信息

Kale Ahmet, Biler Alper, Terzi Hasan, Usta Taner, Kale Ebru

机构信息

Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.

出版信息

Int Braz J Urol. 2017 Sep-Oct;43(5):903-909. doi: 10.1590/S1677-5538.IBJU.2017.0070.

Abstract

OBJECTIVE

To share our first experience with laparoscopic pectopexy, a new technique for apical prolapse surgery, and to evaluate the feasibility of this technique.

MATERIALS AND METHODS

Seven patients with apical prolapse underwent surgery with laparoscopic pectopexy. The lateral parts of the iliopectineal ligament were used for a bilateral mesh fixation of the descended structures. The medical records of the patients were reviewed, and the short-term clinical outcomes were analyzed.

RESULTS

The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period.

CONCLUSION

Although laparoscopic sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical prolapse surgery.

摘要

目的

分享我们在腹腔镜盆底固定术(一种治疗顶端脱垂的新技术)方面的首次经验,并评估该技术的可行性。

材料与方法

7例顶端脱垂患者接受了腹腔镜盆底固定术。使用髂耻韧带的外侧部分对下移结构进行双侧网片固定。回顾患者的病历,并分析短期临床结果。

结果

成功实施了腹腔镜盆底固定术,无术中及术后并发症。在6个月的随访期内,所有患者均未出现新发顶端脱垂、新发尿急、新发便秘、压力性尿失禁、前后侧缺损膀胱膨出和直肠膨出。

结论

尽管腹腔镜骶骨阴道固定术已显示出良好的长期解剖和功能效果,但腹腔镜盆底固定术为顶端脱垂手术提供了一种可行、安全且舒适的替代方法。盆底固定术可能会增加外科医生对顶端脱垂手术的技术视野。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7faa/5678522/bd56670700a1/1677-5538-ibju-43-05-0903-gf01.jpg

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