Abstract
Purpose
To evaluate the learning curve of senior urogynecologic surgeons performing laparoscopic sacral colpopexy (LSCP) and to assess outcomes and complications of LSCP.
Methods
We conducted a retrospective study of 47 consecutive women who underwent LSCP for pelvic organ prolapse repair between March 2009 and December 2010 at one tertiary medical center. Preoperative, intraoperative, postoperative, and demographic data were retrieved from patients’ electronic charts. Pelvic organ support was assessed objectively using the Pelvic Organ Prolapse Quantification scale (POP-Q). Anatomic failure was determined as POP-Q stage ≥ II.
Results
The mean age of patients was 58 years (range 35–73 years). Seven (15 %) who opted to retain their uterus underwent sacrohysteropexies. The median POP-Q was III (II–IV). Of the 47 operations, 96 % (45) were completed by laparoscopy. The duration of surgery decreased as experience of the surgical team increased, from a mean of 196 ± 62 min for the first 15 cases to 162 ± 30 min for the subsequent 30. Four patients (9 %) presented with recurrence of prolapse; three (7 %) had de novo stress urinary incontinence; two sustained a cystotomy during adhesiolysis, and one had a port-site hernia.
Conclusions
LSCP is a safe and effective treatment for pelvic organ prolapse, with very few complications. Following the first 15 cases of one surgical team, operative time decreased considerably.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Addison WA, Livengood CH 3rd, Sutton GP, Parker RT (1985) Abdominal sacral colpopexy with Mersilene mesh in the retroperitoneal position in the management of posthysterectomy vaginal vault prolapse and enterocele. Am J Obstet Gynecol 153:140–146
Akladios CY, Dautun D, Saussine C, Baldauf JJ, Mathelin C, Wattiez A (2010) Laparoscopic sacrocolpopexy for female genital organ prolapse: establishment of a learning curve. Eur J Obstet Gynecol Reprod Biol 149:218–221
Altman D, Anzen B, Brismar S, Lopez A, Zetterstrom J (2006) Long-term outcome of abdominal sacrocolpopexy using xenograft compared with synthetic mesh. Urology 67:719–724
Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113
Benson JT, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1421 (discussion 1421–1422)
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Claerhout F, Roovers JP, Lewi P, Verguts J, De Ridder D, Deprest J (2009) Implementation of laparoscopic sacrocolpopexy—a single centre’s experience. Int Urogynecol J Pelvic Floor Dysfunct 20:1119–1125
Culligan PJ, Murphy M, Blackwell L, Hammons G, Graham C, Heit MH (2002) Long-term success of abdominal sacral colpopexy using synthetic mesh. Am J Obstet Gynecol 187:1473–1480 (discussion 1481–1482)
Cundiff GW, Harris RL, Coates K, Low VH, Bump RC, Addison WA (1997) Abdominal sacral colpoperineopexy: a new approach for correction of posterior compartment defects and perineal descent associated with vaginal vault prolapse. Am J Obstet Gynecol 177:1345–1353 (discussion 1353–1355)
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20
Higgs PJ, Chua HL, Smith AR (2005) Long term review of laparoscopic sacrocolpopexy. BJOG 112:1134–1138
Huguier J, Scali P (1958) Posterior suspension of the genital axis on the lumbosacral disk in the treatment of uterine prolapse. Presse Med 66(35):781–784
Luber KM, Boero S, Choe JY (2001) The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol 184:1496–1501 (discussion 1501–1503)
Maher CF, Feiner B, DeCuyper EM, Nichlos CJ, Hickey KV, O’Rourke P (2011) Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol 204(360):e361–e367
Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ (2004) Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol 190:20–26
Nezhat CH, Nezhat F, Nezhat C (1994) Laparoscopic sacral colpopexy for vaginal vault prolapse. Obstet Gynecol 84(5):885–888
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506
Ross JW (1997) Techniques of laparoscopic repair of total vault eversion after hysterectomy. J Am Assoc Gynecol Laparosc 4:173–183
Rozet F, Mandron E, Arroyo C, Andrews H, Cathelineau X, Mombet A, Cathala N, Vallancien G (2005) Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases. Eur Urol 47:230–236
Conflict of interest
No actual or potential conflict of interest in relation to this article exists.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mustafa, S., Amit, A., Filmar, S. et al. Implementation of laparoscopic sacrocolpopexy: establishment of a learning curve and short-term outcomes. Arch Gynecol Obstet 286, 983–988 (2012). https://doi.org/10.1007/s00404-012-2391-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-012-2391-6