Department of Obstetrics and Gynecology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany; Ethianum Clinic for Plastic, Aesthetic and Reconstructive Surgery, Spine, Orthopedic, Gynecology and Hand Surgery, Heidelberg, Germany.
Department of Obstetrics and Gynecology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
Eur J Obstet Gynecol Reprod Biol. 2020 Jun;249:37-41. doi: 10.1016/j.ejogrb.2020.04.035. Epub 2020 Apr 18.
To show the feasibility of tendon transplantation for minimally invasive pectopexy in pelvic organ prolapse repair.
Patients with uterine or vaginal vault prolapse (POP-Q point C Stage 2-4) were offered laparoscopic pectopexy by means of autologous semitendinosus tendon transplantation. This paper presents a case series and describes the technique regarding the first 10 patients who underwent surgery. After preparing the vagina or cervix for laparoscopic pectopexy a tendon of the patient's semitendinosus muscle was stripped and brought intraabdominally through the 10 mm trocar. The tendon was fixed between the cervix or vagina and to the pectineal ligaments on both sides of the pelvis.
All operations were performed successfully without complications. Vaginal examination demonstrated the intended elevation of the middle compartment. Mobility and power of the affected leg did not change. Recovery was fast, and discharge was possible between the second and third postoperative day.
Our approach demonstrates the feasibility and safety of a laparoscopic pectopexy with a semitendinosus autograft instead of a synthetic mesh. The experience from orthopedic surgery shows that a semitendinosus tendon autograft is long-lasting and stable. In addition, the morbidity on the operated leg is low.
展示在盆底器官脱垂修复中采用微创悬带固定术进行肌腱移植的可行性。
对子宫或阴道穹窿脱垂（POP-Q 点 C 期 2-4 期）的患者，通过自体半腱肌腱移植，采用腹腔镜悬带固定术进行治疗。本文介绍了一个病例系列，并描述了前 10 例接受手术的患者的技术。在为腹腔镜悬带固定术准备阴道或宫颈后，从患者的半腱肌腱中剥离出一条肌腱，并通过 10mm 的 trocar 将其带入腹腔。将肌腱固定在宫颈或阴道与骨盆两侧的耻骨韧带之间。
所有手术均成功完成，无并发症。阴道检查显示中间隔层的预期提升。受影响腿的活动度和力量没有改变。恢复迅速，术后第 2-3 天即可出院。
我们的方法证明了使用半腱肌腱自体移植物而不是合成网进行腹腔镜悬带固定术的可行性和安全性。来自骨科手术的经验表明，半腱肌腱自体移植物持久且稳定。此外，手术腿的发病率较低。
