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使用半腱肌腱进行机器人辅助骶宫颈固定术治疗顶端器官脱垂的初步研究及临床结果分析

Implementation of Robotic-Assisted Sacrocervicopexy for Apical Organ Prolapse Using the Semitendinosus Tendon-Pilot Study and Analysis of Clinical Outcome.

作者信息

Schröder Carolin, Lukannek Charlotte, Egger Eva K, Otten Lucia A, Mustea Alexander, Koensgen Dominique

机构信息

Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

出版信息

Int Urogynecol J. 2025 Mar;36(3):719-723. doi: 10.1007/s00192-024-05975-1. Epub 2024 Nov 12.

Abstract

INTRODUCTION AND HYPOTHESIS

This video demonstrates a robotic-assisted sacrocervicopexy using the semitendinosus tendon.

METHODS

Between June 2022 and February 2023, we performed the worldwide first Da Vinci robotic-assisted sacrocervicopexies (SCP) for apical organ prolapse using the semitendinosus tendon of the left knee. Analysis of safety, feasibility, and clinical outcome of the first ten patients operated on using this new surgical technique included the German pelvic floor questionnaire (GPFQ) as well as a clinical examination.

RESULTS

Ten patients with a follow-up of 12 months were included. There was a significant reduction of the patient's symptoms according to the GPFQ regarding the domain bladder (preoperatively versus 3 months postoperatively, mean 3.85 vs 1.61, p = 0.034), total score (preoperatively versus 3 months postoperatively, mean 12.79 vs 3.28, p = 0.034), and descensus symptoms (preoperatively versus 12 months postoperatively, mean 4.74 vs 0.67, p = 0.022). POP-Q stage (point C) was significantly reduced between the preoperative period and at the time of discharge (mean 2.2 vs 0, p = 0.004). No serious intra- and postoperative complications occurred.

CONCLUSIONS

This pilot study showed satisfying clinical outcomes after a follow-up of 12 months, with a low mid-term complication rate.

摘要

引言与假设

本视频展示了使用半腱肌肌腱进行的机器人辅助骶子宫固定术。

方法

在2022年6月至2023年2月期间,我们使用左膝半腱肌肌腱,为顶端器官脱垂患者进行了全球首例达芬奇机器人辅助骶子宫固定术(SCP)。对采用这种新手术技术进行手术的前十例患者的安全性、可行性和临床结果进行分析,包括使用德国盆底问卷(GPFQ)以及临床检查。

结果

纳入了10例随访12个月的患者。根据GPFQ,患者在膀胱领域(术前与术后3个月,平均3.85对1.61,p = 0.034)、总分(术前与术后3个月,平均12.79对3.28,p = 0.034)以及脱垂症状(术前与术后12个月,平均4.74对0.67,p = 0.022)方面的症状有显著减轻。术前与出院时相比,POP-Q分期(C点)显著降低(平均2.2对0,p = 0.004)。未发生严重的术中和术后并发症。

结论

这项初步研究显示,随访12个月后临床结果令人满意,中期并发症发生率较低。

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