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Inicio Actas Urológicas Españolas (English Edition) Laparoscopic latero-abdominal colposuspension: Description of the technique, adv...
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Vol. 45. Issue 2.
Pages 167-174 (March 2021)
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Vol. 45. Issue 2.
Pages 167-174 (March 2021)
Surgery Workshop
DOI: 10.1016/j.acuroe.2021.01.005
Laparoscopic latero-abdominal colposuspension: Description of the technique, advantages and preliminary results
Colposuspensión latero-abdominal laparoscópica: descripción, ventajas y resultados preliminares
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J.V. Baldissera Aradas
Corresponding author
baldissera758@gmail.com

Corresponding author.
, R. Polo Hernández, F. Merenciano, M. Amat, P. Climent, R. Ferrero Doria
Servicio de Urología, Hospital de Dénia-Marina Salud, Dénia, Alicante, Spain
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Table 1. Demographic and preoperative data.
Table 2. Intraoperative and postoperative data.
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Abstract
Introduction

There are currently various fixation or suspension techniques for pelvic organ prolapse (POP) surgery. Laparoscopic colposacropexy is considered the gold standard. We present the surgical steps of the laparoscopic latero-abdominal colposuspension (LACS) technique and the preliminary results obtained.

Material and methods

Patients with anterior and/or apical compartment symptomatic POP undergoing LACS are included. The Baden-Walker scale, the Overactive Bladder Questionnaire-Short Form (OAB-q SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Patient Global Impression of Improvement (PGI-I) scale were used to assess the degree of prolapse, urinary filling and sexual symptoms and the level of satisfaction before and after surgery, respectively. Conventional laparoscopic material and a polyvinylidene fluoride (PVDF) mesh were used.

Results

Eighteen patients were included with a minimum follow-up time of 6 months. The mean surgical time was 70.3 ± 23.8 min. Anatomic correction of prolapse was seen in all cases. Only one recurrence was detected. High levels of patient satisfaction were achieved.

Conclusion

LACS allowed the anatomical reconstruction of the pelvic floor and proved to be a minimally invasive, fast, effective, safe and reproducible technique. More series are needed to evaluate its role against laparoscopic colposacropexy.

Keywords:
Pelvic organ prolapse (POP)
Latero-abdominal colposuspension (LACS)
Round ligament
Laparoscopic colposacropexy
Resumen
Introducción

En la actualidad existen múltiples técnicas de fijación o suspensión para la cirugía del prolapso de órganos pélvicos (POP). La colposacropexia laparoscópica está considerada el Gold estándar. Presentamos la técnica de colposuspensión latero-abdominal laparoscópica (CSLA) paso a paso y los resultados preliminares obtenidos.

Material y métodos

Se incluyen pacientes con POP sintomáticos del compartimiento anterior y/o apical sometidas a CSLA. Se utilizó la escala Baden-Walker, el cuestionario overactive bladder questionary-short form (OABq-SF), el pelvic organ prolapse/Urinary incontinence sexual questionary (PISQ-12) y la escala de mejoría global del paciente (PGI-I) para valorar el grado del prolapso, síntomas urinarios de llenado y sexuales y el grado de satisfacción respectivamente antes y después de la cirugía. Se utilizó material laparoscópico convencional y una malla de fluoruro de polivinilidelo (PVDF).

Resultados

18 pacientes fueron incluidas con un tiempo mínimo de seguimiento de 6 meses. El tiempo quirúrgico medio fue de 70.3 ± 23.8 min. Se objetivo la corrección anatómica del prolapso en todos los casos. Solo una recidiva fue detectada. Se alcanzaron altos grados de satisfacción de las pacientes.

Conclusión

La CSLA permitió la reconstrucción anatómica del suelo pélvico y demostró ser una técnica minimamente invasiva, rápida, efectiva, segura y reproducible. Son necesarias más series para evaluar su papel frente a la colposacropexia laparoscópica.

Palabras clave:
Prolapso de órganos pélvicos (POP)
Colposuspensión latero-abdominal (CSLA)
Ligamento redondo
Colposacropexia laparoscópica

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