Laparoscopic sacrocolpopexy with a vaginal prosthetic adhesive

Abstract

Study objective: To evaluate the efficacy and safety of vaginal prosthetic adhesive (VPA) during laparoscopic sacrocolpopexy.

Design: Retrospective analysis of 35 first consecutive cases.

Setting: Gynecology Surgery Unit, Bouchard Clinic, Marseille, France.

Patients: Thirty-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).

Procedures: Modified 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 results: The 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%.

Conclusions: The 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.

Keywords: Colle; Cyanoacrylate; Encollage prothétique vaginal; Glue; Laparoscopie; Laparoscopy; Promontofixation; Sacrocolpopexy; Vaginal prosthetic adhesive.