1
|
Yao Y, Wang H, Zhang Q, Teng H, Qi H, Zhang Q. Learning curves for itinerant nurses to master the operation skill of Ti-robot-assisted spinal surgery equipment by CUSUM analysis: A pilot study. PLoS One 2024; 19:e0291147. [PMID: 38466746 PMCID: PMC10927145 DOI: 10.1371/journal.pone.0291147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/23/2023] [Indexed: 03/13/2024] Open
Abstract
This study aimed to investigate the minimum number of operations required for itinerant nurses in the operating room to master the skills needed to operate the Ti-robot-assisted spinal surgery equipment. Additionally, we aimed to provide a corresponding basis for the development of qualification admission criteria and skill training for nurses who cooperate with this type of surgery. Nine operating room itinerant nurses independently performed Ti-robot equipment simulations using a spine model as a tool, with 16 operations per trainee. Four evaluation indices were recorded: time spent on equipment preparation and line connections, time spent on image acquisition and transmission, time spent on surgical spine screw placement planning, and time spent on robot arm operation. Individual and general learning curves were plotted using cumulative sum analysis. The number of cases in which the slope of the individual learning curves began to decrease was 3-11 cases, and the number of cases in which the slope of the general learning curve began to decrease was 8 cases. The numbers of cases in which the learning curves began to decrease in the four phases were the 5th, 8th, 11th, and 3rd cases. Itinerant nurses required at least eight cases to master the equipment operation skills of Ti-robot-assisted spinal surgery. Among the four phases, the image acquisition and transmission phases and the surgical spine screw placement planning phase were the most difficult and must be emphasized in future training.
Collapse
Affiliation(s)
- Yichao Yao
- Department of Operating Room, Baoding First Central Hospital, Baoding, China
| | - Huiyue Wang
- Department of Anesthesiology, Baoding First Central Hospital, Baoding, China
| | - Qi Zhang
- Department of Operating Room, Baoding First Central Hospital, Baoding, China
| | - Haimao Teng
- Department of Operating Room, Baoding First Central Hospital, Baoding, China
| | - Hui Qi
- Department of Orthopedics, Baoding First Central Hospital, Baoding, China
| | - Qian Zhang
- Department of Orthopedics, Baoding First Central Hospital, Baoding, China
| |
Collapse
|
2
|
Pathak A, Wanjari M. Minimally Invasive Colorectal Surgery Techniques. Cureus 2023; 15:e47203. [PMID: 38021760 PMCID: PMC10652800 DOI: 10.7759/cureus.47203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Colorectal surgery has witnessed a transformative shift with the advent of minimally invasive techniques, offering patients reduced postoperative discomfort, shorter hospital stays, and accelerated recovery compared to conventional open surgery. This comprehensive review aims to assess the current state of minimally invasive approaches in colorectal surgery, encompassing various techniques such as single-incision laparoscopic surgery, robot-assisted surgery, and conventional laparoscopic surgery. The article meticulously explores the benefits and drawbacks of each technique, delves into the established criteria for their application, delineates cautious circumstances, and analyzes the outcomes of minimally invasive colorectal surgery. Additionally, the integration of virtual reality and augmented reality for surgical planning and training is discussed, shedding light on the future trajectory of this field. Surgeons and researchers striving to enhance patient care and surgical outcomes in colorectal surgery will find this review article an invaluable resource, presenting crucial components of minimally invasive colorectal surgery and paving the way for continued advancements in the field.
Collapse
Affiliation(s)
- Akash Pathak
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
3
|
Brasoveanu S, Ilina R, Balulescu L, Pirtea M, Secosan C, Grigoraș D, Chiriac D, Bardan R, Margan MM, Alexandru A, Pirtea L. Laparoscopic Pectopexy versus Vaginal Sacrospinous Ligament Fixation in the Treatment of Apical Prolapse. Life (Basel) 2023; 13:1951. [PMID: 37895333 PMCID: PMC10608133 DOI: 10.3390/life13101951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVES To compare the follow-up results of a sacrospinous ligament fixation (SSLF) technique for laparoscopic bilateral fixation of the vagina to the iliopectineal ligament via a PVDF-mesh (laparoscopic pectopexy technique, LP) in terms of cure rate and postoperative complications rate. MATERIAL AND METHODS This prospective study included 160 patients diagnosed with pelvic organ prolapse stage II-IV according to the POP-Q system. Eighty-two patients (51.25%) underwent vaginal sacrospinous ligament fixation and seventy-eight patients (48.75%) underwent the laparoscopic pectopexy procedure. RESULTS The cure rate was high in both groups, 95.12% of the patients (78 out of 82) in the SSLF group and 93.59% of the patients (73 out of 78) in the LP group were cured post surgery, leading to an overall cure rate of 151 out of 160 patients. Pelvic pain was present in 5.00% of all patients, but was notably more frequent in the SSLF group (7, 8.54%) than in the LP group (1, 1.28%). Dyspareunia occurred in 4.37% of all patients, slightly more frequently in the SSLF group (6, 7.32%) than the LP group (1, 1.28%), but without significant difference. CONCLUSIONS The laparoscopic pectopexy procedure has comparably positive follow-up results with the conventional sacrospinous ligament fixation procedure. Both SSLF and LP are effective in the treatment of pelvic organ prolapse, with favorable anatomical and subjective results, a high cure rate and low rates of serious postoperative complications.
Collapse
Affiliation(s)
- Simona Brasoveanu
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Razvan Ilina
- Department of Surgery, Discipline of Surgical Semiology II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ligia Balulescu
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Marilena Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Cristina Secosan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Dorin Grigoraș
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Daniela Chiriac
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Răzvan Bardan
- Department of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Mădălin-Marius Margan
- Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Alexandru Alexandru
- General Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Laurențiu Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| |
Collapse
|
4
|
Sima RM, Crăițan AV, Pleș L, Bobircă F, Amza M, Gorecki GP, Georgescu MT, Hamoud BH. The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies-The Experience of Our Center. Healthcare (Basel) 2023; 11:1752. [PMID: 37372870 DOI: 10.3390/healthcare11121752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Laparoscopy for benign ovarian pathology is the appropriate surgical approach and it has many well-known advantages. Minimal invasive gynecological surgery increases the quality of life of the patient. The learning process of laparoscopy is difficult and requires many interventions to acquire manual skills. The objectives of the study were to assess the learning process of laparoscopy for adnexal pathology surgery performed by beginner laparoscopists. MATERIALS AND METHODS This study included three gynecological surgeons who were beginners in laparoscopy and who were named A, B, and C. We collected information about patients, diagnosis, surgical technique, and complications. RESULTS We have analyzed the data from 159 patients. The most frequent primary diagnosis was functional ovarian cyst, and the laparoscopic cystectomy was performed in 49.1% of interventions. The need to convert a laparoscopy into laparotomy was necessary in 1.3% of patients. There were no cases of reintervention, blood transfusion, or ureteral lesions. The duration of the surgical intervention varied statistically significantly according to patient's BMI and to the surgeon. After 20 laparoscopic interventions, a significant improvement was found in the time needed to perform ovarian cystectomy (operators A and B) and salpingectomy (operator C). CONCLUSIONS The process of learning laparoscopy is laborious and difficult. We found a significant decrease in operating time after a twenty laparoscopic interventions.
Collapse
Affiliation(s)
- Romina-Marina Sima
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- The "Bucur" Maternity, "Saint John" Hospital, 040294 Bucharest, Romania
| | - Anca-Violeta Crăițan
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Liana Pleș
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- The "Bucur" Maternity, "Saint John" Hospital, 040294 Bucharest, Romania
| | - Florin Bobircă
- Department of Surgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Surgery Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania
| | - Mihaela Amza
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- The "Bucur" Maternity, "Saint John" Hospital, 040294 Bucharest, Romania
| | - Gabriel-Petre Gorecki
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, Romania
| | - Mihai-Teodor Georgescu
- "Prof. Dr. Al. Trestioreanu" Oncology Discipline, Carol Davila University of Medicine and Pharmacy, 252 Fundeni St., 050474 Bucharest, Romania
| | - Bashar Haj Hamoud
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, KirrbergerStraße 100, Building 9, 66421 Homburg, Germany
| |
Collapse
|
5
|
Vanella S, Bottazzi EC, Farese G, Murano R, Noviello A, Palma T, Godas M, Crafa F. Minimally invasive colorectal surgery learning curve. World J Gastrointest Endosc 2022; 14:731-736. [PMID: 36438877 PMCID: PMC9693684 DOI: 10.4253/wjge.v14.i11.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022] Open
Abstract
The learning curve in minimally invasive colorectal surgery is a constant subject of discussion in the literature. Discordant data likely reflects the varying degrees of each surgeon’s experience in colorectal, laparoscopic or robotic surgery. Several factors are necessary for a successful minimally invasive colorectal surgery training program, including: Compliance with oncological outcomes; dissection along the embryological planes; constant presence of an expert tutor; periodic discussion of the morbidity and mortality rate; and creation of a dedicated, expert team.
Collapse
Affiliation(s)
- Serafino Vanella
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Enrico Coppola Bottazzi
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Giancarlo Farese
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Rosa Murano
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Adele Noviello
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Tommaso Palma
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Maria Godas
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Francesco Crafa
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| |
Collapse
|
6
|
Szymczak P, Wydra DG, Grzybowska ME. Letter to the Editor about "Laparoscopic pectopexy: the learning curve and comparison with laparoscopic sacrocolpopexy". Int Urogynecol J 2022; 33:2597-2598. [PMID: 35895132 DOI: 10.1007/s00192-022-05303-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Paulina Szymczak
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214, Gdańsk, Poland.
| | - Dariusz Grzegorz Wydra
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | - Magdalena Emilia Grzybowska
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214, Gdańsk, Poland
| |
Collapse
|
7
|
Huang P, Li S, Li P, Jia B. The Learning Curve of Da Vinci Robot-Assisted Hemicolectomy for Colon Cancer: A Retrospective Study of 76 Cases at a Single Center. Front Surg 2022; 9:897103. [PMID: 35846959 PMCID: PMC9276975 DOI: 10.3389/fsurg.2022.897103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Aims Robotic-assisted right hemicolectomy (RARH) has many benefits in treating colon cancer, but it is a new technology that needs to be evaluated. This study aims to assess the learning curve (LC) of RARH procedures with the complete mesoscopic exception and D3 lymph node dissection for colon carcinoma. Methods A retrospective analysis was performed on a consecutive series of 76 patients who underwent RARH from July 2014 to March 2018. The operation time was evaluated using the cumulative sum (CUSUM) method to analyze the LC. The patients were categorized into two groups based on the LC: Phase I and Phase II. Statistical methods were used to compare clinicopathological data on intraoperative and perioperative outcomes at different stages of the study. Results The peak point of the LC was observed in the 27th case. Using the CUSUM method, we divide the LC into two stages. Stage 1 (initial learning stage): Cases 1–27 and Stage 2 (proficiency phase): Cases 28–76. There were no obvious distinctions between the two patients’ essential characteristics (age, sex, body mass index, clinical stage, and ASA score). The mean operation time of each group is 187.37 ± 45.56 min and 161.1 ± 37.74 min (P = 0.009), respectively. The intraoperative blood loss of each group is 170.4 ± 217.2 ml and 95.7 ± 72.8 ml (P = 0.031), respectively. Conclusion Based on the LC with CUSUM analysis, the data suggest that the learning phase of RARH was achieved after 27 cases. The operation time and the intraoperative blood loss decrease with more cases performed.
Collapse
Affiliation(s)
- Pu Huang
- Medical School of Chinese PLA, Beijing, China
- Department of General Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Sen Li
- Medical School of Chinese PLA, Beijing, China
- Department of General Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Peng Li
- Department of General Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Baoqing Jia
- Medical School of Chinese PLA, Beijing, China
- Department of General Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
- Correspondence: Baoqing Jia
| |
Collapse
|
8
|
Gong X, Zhang X, Liu D, Yang C, Zhang R, Xiao Z, Chen W, Chen J. Evaluation of physician experience in achieving non-perfused volume ratio of high-intensity focused ultrasound ablation for uterine fibroids: a multicentre study. J Int Med Res 2022; 50:3000605221102087. [PMID: 35634930 PMCID: PMC9158416 DOI: 10.1177/03000605221102087] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the effect of different levels of physician experience on the high-intensity focused ultrasound (HIFU) ablation of uterine fibroids and to provide a reference for the use of non-perfused volume ratio (NPVR) standards during training. Methods This prospective multicentre study enrolled patients with uterine fibroids. The effect of the physician’s level of experience on the outcomes under different NPVR standards and the learning curve of six centres without HIFU experience were analysed. The impact of patient demographic and clinical characteristics were also evaluated. Results A total of 1352 patients from 20 centres were included in the study. The median NPVRs were 92.00%, 88.10% and 92.86% in the no experience group, inexperienced group and experienced group, respectively. Posterior wall fibroids, lateral wall fibroids and fundus fibroids were inversely correlated with NPVR, while experienced physicians were positively correlated with NPVR. With NPVR ≥ 70% and NPVR ≥ 80% standards, physicians in the no experience group completed the learning curve on the 11th and 16th procedure, respectively. Physicians under a standard of an NPVR ≥ 90% did not complete the learning curve. Conclusions NPVR ≥ 80% is a standard that is worth using for HIFU treatment of uterine fibroids.
Collapse
Affiliation(s)
- Xue Gong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xinyue Zhang
- Department of Ultrasound Medicine, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Dang Liu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Chao Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Rong Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Zhibo Xiao
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Wenzhi Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Jinyun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Ultrasound Ablation Centre, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
9
|
Wu CJ, Huang KJ, Chang WC, Li YX, Wei LH, Sheu BC. Analyzing the learning curve of vaginal pelvic reconstruction surgery with and without mesh by the cumulative summation test (CUSUM). Sci Rep 2022; 12:7025. [PMID: 35488055 PMCID: PMC9054794 DOI: 10.1038/s41598-022-11039-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 04/18/2022] [Indexed: 11/29/2022] Open
Abstract
Women who underwent vaginal pelvic reconstructive surgery with or without mesh consecutively between 2004 and 2018 were retrospectively analyzed to determine the learning curve in vaginal pelvic reconstructive surgery. With cumulative summation (CUSUM) analysis of surgical failure and operation time, we assessed the learning curve of vaginal pelvic reconstructive surgery, including sacrospinous ligament fixation, anterior colporrhaphy, posterior colporrhaphy, and optional vaginal hysterectomy with or without mesh placement. The study is based on two individual surgeons who performed vaginal pelvic reconstructive surgery with or without mesh. Two hundred and sixty-four women with stage III or IV pelvic organ prolapse underwent vaginal pelvic reconstructive surgery by surgeons A or B. The median follow-up time of 44 months ranged from 24 to 120 months. Surgical proficiency was achieved in 32–33 vaginal pelvic reconstructive surgery procedures without mesh and 37–47 procedures in the same surgery with mesh. The total surgical success rates for surgeons A and B were 82.2% and 94.1%, with median follow-up times of 60 and 33 months, respectively. More procedures were needed for the learning curve of vaginal pelvic reconstructive surgery with mesh. Having crossed the proficiency boundary, the surgical success rate and operation time were improved.
Collapse
Affiliation(s)
- Chin-Jui Wu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital , Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 15F, No. 8, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 15F, No. 8, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Ying-Xuan Li
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 15F, No. 8, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Lin-Hung Wei
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 15F, No. 8, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 15F, No. 8, Chung-Shan South Road, Taipei, 10002, Taiwan.
| |
Collapse
|
10
|
Perioperative and Long-Term Anatomical and Subjective Outcomes of Laparoscopic Pectopexy and Sacrospinous Ligament Suspension for POP-Q Stages II-IV Apical Prolapse. J Clin Med 2022; 11:jcm11082215. [PMID: 35456313 PMCID: PMC9029245 DOI: 10.3390/jcm11082215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/19/2022] [Accepted: 04/12/2022] [Indexed: 02/03/2023] Open
Abstract
The aim of this paper was to analyze perioperative and long-term outcomes in 114 women undergoing surgery for POP-Q ≥ 2 apical prolapse: sacrospinous ligament colpo/hysteropexy (SSLF/SSHP)—61; laparoscopic pectopexy (LP)—53. Validated questionnaires (PGI-I, ISI, #35 EPIQ, PFIQ-7, PFDI-20) were completed at baseline and follow-up. POP-Q stages II, III and IV were diagnosed in 1 (0.9%), 84 (73.7%) and 29 (25.4%) patients, respectively. Mean operative time and hospital stay were 151.8 ± 36.2 min/2.6 ± 1.1 days for LP and 69 ± 20.4 min (p < 0.001)/2.7 ± 1.0 days for SSLF. Severe intraoperative complications occurred in two (1.8%) patients. Mean follow-up was 26.9 ± 12 and 37.3 ± 17.5 months for LP and SSLF, respectively. At follow-up, significant improvement for all POP-Q points was observed in both groups (p < 0.001). Shortening of total vaginal length was found in both groups, but predominantly in SSLF patients (p = 0.01). The sensation of vaginal bulge (EPIQ) was reduced, and total PFDI-20 and PFIQ-7 scores improved (p < 0.04) in both groups. Subjective success was reported by 40 (75.5%) LP and 44 (72.1%) SSLF patients. ISI detected no deterioration in urinary incontinence. PGI-I, PFDI-20, #35 EPIQ, PFIQ-7 and ISI did not differ between the groups. In conclusion both, SSLF and LP for apical prolapse generate good anatomical and subjective outcomes, with protective effect on the anterior compartment observed for LP.
Collapse
|