Page 42 - Jourmal of World Association of Laparoscopic Surgeon
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B Lavanya
Complications/notes 33 supracervical hysterectomy, 3 transobturator slings, 4.1% complication rate 2.8% complication rate, comparison of 33 anterior only vs 71 ant/post, concomitant SUI surgery 74.1% 18% posterior failure, 11% complication rate (6 mesh erosions), Q follow-up in multiple domains Burch in 74, SCH in 60, 7.2% conversion rate, 5% complication rate Bladder injury 7%, mesh erosion 2%, recurrent rectocele in 12% Vyprol (absorbable) mesh u
Table 1: Outcomes: laparoscopic and robotic mesh sacrocolpopexy series
Definition of success No recurrent prolapse POP ≥ grade 2 POP-Q ≥ – 1 any point No recurrent prolapse No recurrence ≥ grade 2 No recurrent vaginal vault prolapse No apical prolapse Reoperation for prolapse No recurrence >grade 2 No recurrent prolapse Anatomic cure Stage 0 in all compartments on POP-Q Not defined No recurrent prolapse POP-Q scores Not defined POP-Q scores No apical prolapse
Success rate 96% 75% 78% (2% apical) 94% 83% 95% 100% 78% subjective 75% objective 88% 93% 96% 92% objective 98% subjective 90% 97% 100% 95% NR 95% OT: Operative time; LOS: Length of stay; NR: Not reported; LSC: Laparoscopic sacrocolpopexy; SCH: Supracervical hysterectomy; SUI: Stress urinary incontinence 25
Mean follow-up (months) 16 17 13 11 ?? 43 7 34 (13-60) 34 NR* (all have 5-year follow-up) 15 12 16 5 3 24 NR 25
Mean LOS (days) 4 (3-15) 7 (2-32) 5.7 3.5 (2-7) 4.0 ± 2.1 3 (2-7) 1.5 4 (2-21) 5 NR 4 (2-7) 4.6 (2-8) 2 (1.5-3) 2.6 2.4 (1-7) 1 (1-2) 1.3 1.1
Mean OT (min) 237 261 ± 79 180 276 171 ± 37 NR 183 129 191 ± 50 96 ± 42 97 141 196 198 317 186 328 ± 55 194
Mean age (years) 56 (36-78) 59 (36-79) 65 ± 10 47 (28-66) 59 (41-76) 67 (58-76) 60 58 (30-83) 60 ± 9.5 67 (41-83) 63 (35-78) 62 (36-81) 61 (43-83) 67 ± 8.3 64 (50-79) 67 (47-83) 60 66 (52-86)
Author (year) Laparoscopic sacrocolpopexy Akladios et al (2010) 7 (n = 48) Antiphon et al (2004) 8 (n = 108) Claerhout et al (2009) 9 (n = 132) Cosson et al (2002) 10 (n = 77) Gadonneix et al (2004) 11 (n = 46) Granese et al (2009) 12 (n = 165) Klauschie et al (2009) 13 (n = 43) Marcickiewicz et al (2007) 14 (n = 60) Rivoire et al (2007) 15 (n = 138) Ross and Preston (2005) 16 (n = 43) Rozet et al (2005) 17 (n = 363)
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