Kuroda Kenji, Hamamoto Koetsu, Kawamura Kazuki, Masunaga Ayako, Horiguchi Akio, Ito Keiichi
Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan.
Gynecol Minim Invasive Ther. 2025 Mar 15;14(2):157-164. doi: 10.4103/gmit.gmit_155_23. eCollection 2025 Apr-Jun.
The standard laparoscopic sacrocolpopexy (LSC) technique involves several suture fixation sites, which can prolong the operative time. This study aimed to investigate the extent to which the operative time could be shortened using devices such as tackers in sites where suture manipulation could be omitted.
The study enrolled 82 patients who underwent LSC at our hospital between May 2016 and May 2022. The median operative time was 3.2 h (1.78-6.5 h). Changes in symptoms before and after surgery were measured using several questionnaires and 60-min pad weight testing among patient groups based on the device used.
Among the preoperative factors, no factors were found to be significantly correlated with the operative time (≥3.2 h or <3.2 h). As intraoperative factors, significant associations were found between the number of tackers used on the posterior vaginal wall, anterior vaginal wall, and cervix (0-3 locations), whether a device was used in mesh retroperitonealization, whether the first needle used to fix the anterior longitudinal ligament was successful, whether adhesion dissection was performed, and the type of sealing device. Among these factors, the use of tackers on the posterior wall, anterior wall, and cervix and the use of a device in mesh retroperitonealization were significantly associated with the operative time.
The use of easy-to-operate devices appeared to contribute to a shorter operative time in LSC.
标准腹腔镜骶骨阴道固定术(LSC)技术涉及多个缝合固定部位,这可能会延长手术时间。本研究旨在探讨在可省略缝合操作的部位使用诸如钉合器等器械能在多大程度上缩短手术时间。
本研究纳入了2016年5月至2022年5月期间在我院接受LSC的82例患者。中位手术时间为3.2小时(1.78 - 6.5小时)。根据使用的器械,在患者组中使用几份问卷和60分钟的卫生巾重量测试来测量手术前后症状的变化。
在术前因素中,未发现有因素与手术时间(≥3.2小时或<3.2小时)显著相关。作为术中因素,发现阴道后壁、阴道前壁和宫颈(0 - 3个部位)使用钉合器的数量、在网片腹膜后置入时是否使用器械、用于固定前纵韧带的第一针是否成功、是否进行粘连松解以及密封装置的类型之间存在显著关联。在这些因素中,阴道后壁、前壁和宫颈使用钉合器以及在网片腹膜后置入时使用器械与手术时间显著相关。
使用易于操作的器械似乎有助于缩短LSC的手术时间。