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Archives of Gynecology and Obstetrics

, Volume 298, Issue 5, pp 939–944 | Cite as

Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial

  • Andrea Morciano
  • Giuseppe Marzo
  • Dario Caliandro
  • Giuseppe Campagna
  • Giovanni Panico
  • Simona Alcaino
  • Tatiana Bisanti
  • Alfredo Ercoli
  • Daniela Romualdi
  • Giovanni Scambia
General Gynecology
  • 33 Downloads

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Sacral colpopexy Laparoscopy Continuous suture Running suture Mesh fixation Pelvic organ prolapse 

Notes

Author contribution

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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Andrea Morciano
    • 1
  • Giuseppe Marzo
    • 1
  • Dario Caliandro
    • 1
  • Giuseppe Campagna
    • 2
  • Giovanni Panico
    • 2
  • Simona Alcaino
    • 1
  • Tatiana Bisanti
    • 1
  • Alfredo Ercoli
    • 3
  • Daniela Romualdi
    • 1
    • 2
  • Giovanni Scambia
    • 2
  1. 1.Department of Gynaecology and ObstetricsPia Fondazione “Card. G. Panico”LecceItaly
  2. 2.Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario “A. Gemelli”Università Cattolica del Sacro CuoreRomeItaly
  3. 3.Department of Gynaecology and ObstetricsUniversità degli Studi del Piemonte Orientale ‘‘Amedeo Avogadro’’NovaraItaly

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