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Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Sacrocolpopexy: A Pilot Study of 26 Cases.

Abstract：

STUDY OBJECTIVE:To describe the surgical technique and short-term outcomes for 26 cases of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) sacrocolpopexy for the treatment of pelvic organ prolapse (POP). DESIGN:Retrospective case series study (Canadian Task Force classification II-2). SETTING:Academic tertiary care university hospital in Guangdong, China. PATIENTS:Women diagnosed with stages II to IV POP between May 2017 and May 2018. INTERVENTIONS:vNOTES sacrocolpopexy. MEASUREMENTS AND MAIN RESULTS:A total of 26 patients were identified. vNOTES sacrocolpopexy was standardized after case 4, and 23 cases were completed successfully. Operative duration was a median of 184 minutes (interquartile range, 158.5-202.5), and mean estimated blood loss was 30.87 ± 20.8 mL. Mean pre- and postoperative POP Quantification System scores for the Aa point were, respectively, 1.4 ± 1.7 cm (range, -2 to 3) versus -1.85 ± .6 cm (p <.0001) and for the C point were 2.2 ± 1.9 cm (range, -1 to 5) versus -6.1± .7 cm (p <.0001). Mean pre- and postoperative Pelvic Floor Impact Questionnaire scores were 163.1 ± 46.2 versus 18.4 ± 29.3 (p <.0001). These suggest significant improvements in both physical prolapse and quality of life at 1 month after surgery. There were no complications of mesh exposure, pain, hematoma, infection, or new urinary incontinence. CONCLUSION:vNOTES is a feasible approach for sacrocolpopexy, with promising short-term efficacy and safety data. Larger studies across multiple sites and surgeons should evaluate the long-term efficacy and safety profile of vNOTES sacrocolpopexy.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Liu J,Kohn J,Fu H,Guan Z,Guan X

doi

10.1016/j.jmig.2018.08.009

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

748-753

issue

4

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(18)30424-2

journal_volume

26

pub_type

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