Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
September 13th, 2022
The present pilot study describes the development of laparoscopic non-mesh cerclage pectopexy to treat pelvic organ prolapse. The procedure can be used to prevent any complications associated with the use of mesh.
The laparoscopic non-mesh cerclage pectopexy is developed to treat pelvic organ prolapse eliminating mesh erosion complications. LNMCP avoids using synthetic mesh, thereby eliminating any risk of related complications and reducing the medical expenses for the patients. To begin, expose the iliopectineal ligament near the landmarks, including the round ligament and the obliterated umbilical artery.
Make an eight-centimeter-long incision in the peritoneum along the inner edge of the round ligament toward the pelvic wall until the iliopectineal ligament is reached. Locate the posterior aspect of the iliopectineal ligament immediately below the external iliac vein. Then, perform cervical cerclage by suturing, ligating, and attaching a round ligament to the cervical stump in the uterine isthmus using a permanent suture beginning on the right side and moving in the counterclockwise direction.
Perform peripheral movements with the needle around the cervix to complete one round until the starting position. Upon completing the cervical cerclage, tighten and suture the stitch. Embed the suture in the round ligament until the iliopectineal ligament.
Insert the suture through the iliopectineal ligament to ensure tension-free anchoring and perform re-peritonealization with an absorbable suture. LNMCPP was performed successfully in 16 patients. The calculated mean age was 58.5 years, the mean estimated blood loss was 73.1 milliliters, and the mean operation time was 67.8 minutes.
All women visited the hospital for follow-up after a mean duration of 6.6 months. An objective success rate of 100%was observed until the last follow-up, while the subjective success rate was 93.8%Permanent cervical cerclage sutures are embedded in the round ligament until the iliopectineal ligament. The suturing of the iliopectineal ligament is achieved from cervical suspension.
Overview
This pilot study presents the laparoscopic non-mesh cerclage pectopexy (LNMCP) as a novel approach to treat pelvic organ prolapse. The technique aims to eliminate complications associated with synthetic mesh, thereby enhancing patient safety and reducing costs.
Key Study Components
Area of Science
- Gynecology
- Minimally invasive surgery
- Pelvic health
Background
- Pelvic organ prolapse is a common condition affecting many women.
- Traditional treatments often involve synthetic mesh, which can lead to complications.
- LNMCP offers a non-mesh alternative to address these issues.
- The procedure focuses on cervical support without the risks associated with mesh erosion.
Purpose of Study
- To develop and assess the effectiveness of LNMCP for pelvic organ prolapse.
- To evaluate the safety and outcomes of the procedure in patients.
- To provide a cost-effective solution for treating pelvic organ prolapse.
Methods Used
- Identification of the iliopectineal ligament and surrounding landmarks.
- Creation of an incision in the peritoneum to access the ligament.
- Execution of cervical cerclage using permanent sutures.
- Follow-up assessments to evaluate surgical outcomes and complications.
Main Results
- LNMCP was successfully performed on 16 patients.
- Mean age of participants was 58.5 years.
- Mean estimated blood loss was 73.1 milliliters.
- Objective success rate was 100%, with a subjective success rate of 93.8% at follow-up.
Conclusions
- LNMCP is a safe and effective method for treating pelvic organ prolapse.
- The procedure eliminates the risks associated with synthetic mesh.
- Further studies are recommended to validate long-term outcomes.
