The current status of laparoscopic sacrocolpopexy: a review.
BACKGROUND
Pelvic organ prolapse (POP) is a common problem in women that causes morbidity and a decreased quality of life. Sacrocolpopexy can treat women with vaginal vault prolapse (VVP), multicompartmental POP, and/or a history of failed prolapse procedures. Abdominal sacrocolpopexy (ASC) is the gold standard for VVP and is superior to vaginal sacrocolpopexy, with fewer recurrent prolapses and less dyspareunia. Vaginal prolapse repairs, however, are often faster and offer patients a shorter recovery time. Laparoscopic sacrocolpopexy (LSC) aims to bridge this gap and to provide the outcomes of ASC with decreased morbidity.


OBJECTIVE
This review evaluates the recent literature on LSC as a therapy for POP.


METHODS
A PubMed search of the available English literature on LSC was performed. The reference lists of selected articles were reviewed, and additional on-topic articles were included. Some 50 articles were screened, 22 articles were selected, and the reported outcomes from 11 series are presented in this review.


RESULTS
Laparoscopic experience with POP has advanced tremendously, and LSC results from >1000 patients in 11 series support this. Conversion rates and operative times have decreased with increased experience. Mean operative time was 158 min (range: 96-286 min) with a 2.7% conversion rate (range: 0-11%) and a 1.6% early reoperation rate (range: 0-3.9%). With a mean follow-up of 24.6 mo (range: 11.4-66 mo), there was, on average, a 94.4% satisfaction rate, a 6.2% prolapse reoperation rate, and a 2.7% mesh erosion rate. Several centers have demonstrated that excellent outcomes with LSC are reproducible in terms of operative parameters, durable results, minimal complications, and high levels of patient satisfaction.


CONCLUSIONS
LSC upholds the outcomes of the gold standard ASC with minimal morbidity. Longer prospective and randomized trials are needed to confirm these results.
Ganatra
Anjali M
AM
Department of Urology, Institut Montsouris, Université Paris Descartes, Paris, France.
Rozet
François
F
Sanchez-Salas
Rafael
R
Barret
Eric
E
Galiano
Marc
M
Cathelineau
Xavier
X
Vallancien
Guy
G
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011788:Quality of Life; D018570:Risk Assessment; D012371:Robotics; D013526:Surgical Mesh; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*