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Abstract:
INTRODUCTION:Laparoscopic sacrocolpopexy (LS) is considered a safe and effective surgery for the treatment of pelvic organ prolapse (POP), but it requires expertise in laparoscopic surgery. The complexity of the intervention is due to the requirements of intracorporeal sutures and the manipulation of the mesh inside the cavity, which may be cumbersome. The barbed sutures (BS) simplify intracorporeal suturing and do not require knotting. Additionally, one-piece U-mesh (OP-UM) may facilitate handling, stabilization and tension adjustment. We describe our LS surgical technique using both materials to assess its feasibility, safety and effectiveness in a prospective series of patients. MATERIALS AND METHODS:A total of 7 patients with symptomatic pelvic organ prolapse were included. Urogynecological history, classification of the pelvic organ prolapse according to Baden-Walker and the application of the Prolapse Quality of Life questionnaire were performed in all cases. The non-absorbable polypropylene OP-UM (Uplift ™) was used. The posterior side of the single sling is sutured to the elevator anus muscles with two non-absorbable stitches. Two strands of BS (V-Loc™), tied at their ends, were used to attach the mesh to the vagina in two lines of continuous sutures in opposite directions. Self-anchoring tackers were used for promontofixation and BS for peritoneal closure. RESULTS:The median age was 60 years, the median time of the anterior branch mesh BS fixation was 23minutes (range 21,30 - 26,40min), intraoperative bleeding was minimal, and the median hospital stay was 3 days. No intraoperative complications were recorded, and no mesh erosions or recurrences were observed at a median follow-up of 14 months (range 3-25 months). All patients presented clinical improvement of the prolapse and were satisfied with surgery. We observed that the OP-UM self-stabilizes when it extends longitudinally into the abdominal cavity, reducing the need of the surgical assistant. The independent promontofixation of each part of the mesh (posterior and anterior) allows a more anatomical tension adjustment. Fixing the mesh to the vagina is fast and simple with our BS technique. CONCLUSIONS:The use of OP-UM and BS during LS is feasible, safe, effective and could simplify this surgical technique.
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最新影响因子:0.887 | 期刊ISSN:0210-4806 | CiteScore:0.98 |
出版周期:Monthly | 是否OA:YES | 出版年份:1977 |
期刊官方网址:http://www.journals.elsevier.com/actas-urologicas-espanolas/
期刊投稿地址:http://www.journals.elsevier.com/actas-urologicas-espanolas/
自引率:48.30% | 研究方向:UROLOGY & NEPHROLOGY- |
出版地区:SPAIN |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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Published by SciELO. ISSN: 0210-4806. Publication of the Asociación Española de Urología. Mission: To publish spanish articles as any other relevant information relate
由希洛出版。国际标准编号:0210-4806。 出版了《经济及社会理事会正式记录》。任务:在任何其他有关资料涉及时发表西班牙文文章
大类(学科) | 小类(学科) | 学科排名 |
医学 |
UROLOGY & NEPHROLOGY (泌尿学与肾脏学) 4区 |
61/76 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
81 | 70 | 11 |
引文计数(2018)
文献(2015-2017)
331次引用
339篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Urology
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