Laparoscopic sacrocolpopexy with a vaginal prosthetic adhesive

Abstract

Study objectiveTo evaluate the efficacy and safety of vaginal prosthetic adhesive (VPA) during laparoscopic sacrocolpopexy. DesignRetrospective analysis of 35 first consecutive cases. SettingGynecology Surgery Unit, Bouchard Clinic, Marseille, France. PatientsThirty-five women (age range: 35–85 years; average 60.8 years) presenting a genital prolapse assessed by a Pelvic Organ Prolapse Quantification (POP-Q) Score (stage 2 to 4). ProceduresModified laparoscopic sacrocolpopexy using a synthetic glue (Ifabond™, Peters Surgical®) to fix the mesh to the vagina (anterior and posterior) and to the levator ani. Two non-absorbable knots are used to secure the anterior mesh to the isthmus and to the promontory. Measurements and main resultsThe average operating time was 68.4 minutes (45–115 min). No complications occurred during the procedure and early postoperative course. One patient (2.8%) experienced mesh exposure, and one patient (2.8%) experienced a subacute intestinal obstruction, which was resolved by a medical treatment. During a median follow-up at 13.2 months (range: 6–24.7 months), the surgical success rate (POP-Q<2) was 94.2% (two recurrences). The patient satisfaction rate was 87%. ConclusionsThe VPA during laparoscopic sacrocolpopexy seems to be safe and effective at short term. This new procedure due to adhesive opens up a new path for the widespread use of sacrocolpopexy and for reduced operating times, which is often one obstacle with the dissection in the development of this technique.