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01-11-2018 | General Gynecology

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

Authors: Andrea Morciano, Giuseppe Marzo, Dario Caliandro, Giuseppe Campagna, Giovanni Panico, Simona Alcaino, Tatiana Bisanti, Alfredo Ercoli, Daniela Romualdi, Giovanni Scambia

Published in: Archives of Gynecology and Obstetrics | Issue 5/2018

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.

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Title: Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial
Authors: Andrea Morciano
Giuseppe Marzo
Dario Caliandro
Giuseppe Campagna
Giovanni Panico
Simona Alcaino
Tatiana Bisanti
Alfredo Ercoli
Daniela Romualdi
Giovanni Scambia
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-4916-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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