Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial
Laparoscopic sacral colpopexy (LSC) plus supracervical hysterectomy (LSH) for pelvic organ prolapse (POP) is a high-complexity surgical procedure. The aim of the present study was to evaluate a new approach to vaginal-mesh fixation during LSC with continuous locked suture.
This is a prospective randomized double-blinded clinical trial enrolling 90 patients with severe POP from January 2016 to April 2017. Patients underwent LSH plus a “two-meshes” LSC and were randomized, regarding mesh fixation, in Group 1 (extracorporeal interrupted 3-0 delayed absorbable sutures) and Group 2 (running locked 3-0 delayed absorbable suture). Our primary endpoints were the operative times and the secondary endpoints the incidence of intra- or post-operative complications.
A total of 42 patients for group completed the study. Baseline characteristics were similar between the groups. Overall mesh fixation time (24 vs. 39 min; p < 0.01), and operative time (121 vs. 138 min; p < 0.05) resulted significantly lower in Group 2. No differences were found in terms of anatomic failure, vaginal mesh erosion or intra- or post-operative complications.
Laparoscopic continuous locked 3-0 absorbable suture for anterior and posterior mesh fixation during LSC guaranteed a faster and effective alternative to multiple interrupted sutures. The significant operative time reduction linked to this technique should be considered even more helpful when performing a highly complex surgery such as LSC.
KeywordsSacral colpopexy Laparoscopy Continuous suture Running suture Mesh fixation Pelvic organ prolapse
AM: project development, data analysis, manuscript writing; GM: project development, data collection; DC: data management; GC: manuscript editing; GP: data collection; SA: manuscript writing; TB: patients’ enrollment; AE: project development, manuscript editing and revising; DR: manuscript editing and revising; GS: manuscript editing and revising.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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