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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)939-944
Number of pages6
JournalArchives of Gynecology and Obstetrics
Volume298
Issue number5
DOIs
Publication statusPublished - Nov 2018

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Sutures
Randomized Controlled Trials
Operative Time
Pelvic Organ Prolapse
Hysterectomy
Clinical Trials
Incidence

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Laparoscopic sacral colpopexy and a new approach to mesh fixation : a randomized clinical trial. / Morciano, Andrea; Marzo, Giuseppe; Caliandro, Dario; Campagna, Giuseppe; Panico, Giovanni; Alcaino, Simona; Bisanti, Tatiana; Ercoli, Alfredo; Romualdi, Daniela; Scambia, Giovanni.

In: Archives of Gynecology and Obstetrics, Vol. 298, No. 5, 11.2018, p. 939-944.

Research output: Contribution to journalArticle

Morciano, A, Marzo, G, Caliandro, D, Campagna, G, Panico, G, Alcaino, S, Bisanti, T, Ercoli, A, Romualdi, D & Scambia, G 2018, 'Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial', Archives of Gynecology and Obstetrics, vol. 298, no. 5, pp. 939-944. https://doi.org/10.1007/s00404-018-4916-0
Morciano, Andrea ; Marzo, Giuseppe ; Caliandro, Dario ; Campagna, Giuseppe ; Panico, Giovanni ; Alcaino, Simona ; Bisanti, Tatiana ; Ercoli, Alfredo ; Romualdi, Daniela ; Scambia, Giovanni. / Laparoscopic sacral colpopexy and a new approach to mesh fixation : a randomized clinical trial. In: Archives of Gynecology and Obstetrics. 2018 ; Vol. 298, No. 5. pp. 939-944.
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AU - Morciano, Andrea

AU - Marzo, Giuseppe

AU - Caliandro, Dario

AU - Campagna, Giuseppe

AU - Panico, Giovanni

AU - Alcaino, Simona

AU - Bisanti, Tatiana

AU - Ercoli, Alfredo

AU - Romualdi, Daniela

AU - Scambia, Giovanni

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N2 - 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.

AB - 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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