Jain Nidhi, Kamra Jyotsna, Srinivas Shruthi
Department of OBG, Maharaja Agrasen Medical College, Agroha, Hisar, Haryana India.
Goel Nursing Home, Tohana Road, Fatehabad, Ratia, 125051 India.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):1-8. doi: 10.1007/s13224-023-01937-7. Epub 2024 Jun 24.
Pelvic organ prolapse is a common gynecological disorder seen in Asian women, more in rural area. It is seen in both old age and young women. Presenting complaints includes something coming out of vagina, chronic pelvic pain, urinary and bowel symptoms. Sacrohysteropexy is the gold standard procedure for its management. Recently, laparoscopic pectopexy is described as a new alternative procedure, which is equally effective and associated with far lesser complications. Thus, this study is conducted to see the outcomes of laparoscopic pectopexy.
This retrospective observational study is conducted in the department of obstetrics and gynecology, over the period of three years. Thirty-five patients, operated by laparoscopic pectopexy, were included in study. Twenty-five cases were young patient with prolapse, while 10 patients were of vault prolapse. Inclusion criteria were POP-Q stage ≥ II. All cases were done by same surgical team. Data were analyzed in terms of demographic profile. Video recording of surgery were checked to calculate operating time and estimated blood loss. All intraoperative and postoperative complications were recorded. Follow-up was done at 1 month and 6 months.
Out of 35 cases, 10 were vault prolapse and 25 cases were uterine prolapse. No major intraoperative complications like visceral injury and major hemorrhage were found. Average operating time was 96 min. Average estimated blood loss was 50-100 ml. All patients were followed up at 1 month, 3 months and 6 months postoperatively. All patients were highly satisfied with surgery. None of the patients had de novo apical prolapse/recurrence of symptoms.
Laparoscopic pectopexy is a novel promising technique to manage prolapse with minimal intraoperative and postoperative complications. It is a safe and feasible alternative to sacropexy. So, it should be considered as a first-line surgery for management of apical prolapse.
盆腔器官脱垂是亚洲女性常见的妇科疾病，在农村地区更为多见。老年女性和年轻女性均可发病。主要症状包括阴道内有肿物脱出、慢性盆腔疼痛、泌尿系统和肠道症状。骶骨子宫固定术是治疗该病的金标准术式。近来，腹腔镜盆底固定术被描述为一种新的替代术式，其疗效相当且并发症少得多。因此，本研究旨在观察腹腔镜盆底固定术的治疗效果。
本回顾性观察性研究在妇产科进行，为期三年。纳入35例行腹腔镜盆底固定术的患者。其中25例为年轻的脱垂患者，10例为穹隆脱垂患者。纳入标准为盆腔器官脱垂定量分期（POP-Q分期）≥Ⅱ期。所有病例均由同一手术团队完成。对人口统计学资料进行分析。查看手术录像以计算手术时间和估计失血量。记录所有术中及术后并发症。在术后1个月和6个月进行随访。
35例患者中，10例为穹隆脱垂，25例为子宫脱垂。未发现诸如内脏损伤和大出血等严重术中并发症。平均手术时间为96分钟。平均估计失血量为50 - 100毫升。所有患者在术后1个月、3个月和6个月均进行了随访。所有患者对手术高度满意。无一例患者出现新的顶端脱垂/症状复发。
腹腔镜盆底固定术是一种治疗脱垂的有前景的新技术，术中及术后并发症极少。它是骶骨固定术安全可行的替代方法。因此，应将其视为顶端脱垂治疗的一线手术方式。
