AI Article Synopsis
- Vaginally assisted laparoscopic sacrocolpopexy (VALS) offers a new surgical alternative for treating uterovaginal prolapse by combining vaginal and laparoscopic techniques to improve outcomes.
- In a study comparing 47 women undergoing VALS with 32 women undergoing abdominal sacrocolpopexy (AS), VALS resulted in shorter operating times (125.9 minutes vs. 151.9 minutes) and shorter hospital stays (1 day vs. 3 days).
- Both procedures had similar complication rates and rates of failure or recurrence, suggesting VALS is a safe and effective approach, particularly for those less experienced with laparoscopic techniques.
Article Abstract
Objective: Vaginally assisted laparoscopic sacrocolpopexy (VALS), which is a combined surgical approach where a vaginal hysterectomy is initially performed, followed by transvaginal placement of synthetic mesh and laparoscopic suspension, can be an alternative to overcome the dissection, suturing limitations of laparoscopic sacrocolpopexy. The aim of this study was to compare the operative times and middle-term anatomic outcomes of women with uterovaginal prolapse undergoing VALS with those of women undergoing abdominal sacrocolpopexy.
Methods: This is a prospective cohort study that evaluates operation times, anesthesia times, estimated blood loss, middle-term outcomes, perioperative and postoperative complications. We compared the results of 47 women who had the VALS to that of 32 abdominal sacrocolpopexy (AS).
Results: The mean follow up was 22.4 months for AS group and 20.5 months for VALS group. The VALS group (median 1 day) had shorter hospitalization duration than the AS group (median 3 days). The mean operation time was significantly shorter in the VALS group (125.9 minutes) than the AS group (151.9 minutes) (P = .03). There was no significant difference in perioperative and postoperative complication rates. Objective failure rate (8.5% in VALS, 15.6% in AS), subjective failure rates (6.4% in VALS, 9.4% in AS), recurrence (2.1% in VALS, 9.4% in AS) and mesh exposition rates (2.1% in VALS, 9.4% in AS) were similar in both procedures.
Conclusions: VALS with shorter operative time and hospitalization than conventional AS is a promising modification minimally invasive technique for sacrocolpopexy especially for those inexperienced in laparoscopic sacrocolpopexy.
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| http://dx.doi.org/10.1111/luts.12369 | DOI Listing |
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