Laparoscopic Sacrocolpopexy - A Retrospective Study
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 5
Abstract
Post-hysterectomy vaginal vault prolapsed is a common complication following different types of hysterectomy which can lead to significant urinary, anorectal and sexual impairment in the patients. Pre existing pelvic floor defect is the most important predicting factor in the future development of vaginal vault prolapse. Preventive measures can be taken intraoperatively to reduce the incidence of later development of vault prolapse but the possibility cannot be eliminated completely. Both vaginal and abdominal approaches have been advocated for the correction of vault prolapse. With the abdominal approach, the results are better and recurrence is less. However, recovery time is more and the procedure requires a lot of bowel manipulation. Laparoscopic sacrocolpopexy can circumvent the disadvantages of open abdominal approach while retaining its advantages of great patient satisfaction and less recurrence. Being a minimally invasive procedure, lap sacrocolpopexy allows for less blood loss and speedy recovery. Here, we present a retrospective analysis of 25 cases of laparoscopic sacrocolpopexy over 2 years. The incidence of vault prolapsed in post hysterectomies patients is estimated to be 0.2-44% [1,2] and is especially common in parous patients with vaginal deliveries and in patients who have previously undergone hysterectomy for uterine prolapsed [3,4]. The risk increases even more in patients who have undergone previous hysterectomy in view of prolapse uterus [5]. Numerous surgical procedures are described for the management of vault prolapse. Vaginal repair is associated with less postoperative pain and early recuperation as compared to abdominal approach. However, abdominal sacrocolpopexy has better anatomical outcome [6]. Laparoscopic sacrocolpopexy seems to be a promising approach which can provide the result of abdominal sacrocolpopexy with decreased morbidity. The success rate of laparoscopic sacrocolpopexy has been reported by a number of authors to be 90–98% [7]. However, the limitation of lap sacrocolpopexy is that it requires extensive dissection and advanced suturing skills. 25 women with vault prolapse who underwent laparoscopic sacrocolpopexy over a period of 2 years at our institute (September 2013 to October 2015) were included in this study. Parameters recorded include age, parity, BMI, previous pelvic surgery ; its indication and route, concomitant surgical procedure, duration of surgery, estimated blood loss, duration of hospital stay and postoperative minor and major complications. All patients were assessed clinically and prolapsed was graded on the Baden- Walker scale at all sites preoperatively as well as postoperatively during follow up at 1 week, 3months, 6 months and 1 year. Preoperatively and at each postop follow up, patient was also asked to fill a standard Pelvic floor distress inventory questionnaire for subjective assessment of the prolapse.
Authors and Affiliations
Kavitha D Yogini, Rashmi Barnwal, Devi Balasubramaniam, Chinnusamy Palanivelu
Keywords
Related Articles
- EP ID EP582156
- DOI 10.26717/BJSTR.2017.01.000462
- Views 177
- Downloads 0
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