title: Surgical Outcomes of a Combined Surgical Approach for Apical Prolapse Repair.
abstract: Introduction We aimed to evaluate the safety, efficacy and surgical outcomes of combined laparoscopic/vaginal prolapse repair by two surgeons. Material and Methods A retrospective chart review of all patients (n = 135) who underwent apical prolapse repair from February 2009 to December 2012 performed in a collaborative manner by a Minimally Invasive Gynecologic Surgeon and a Urogynecologist. Demographic data (age, body mass index [BMI], race, gravidity, parity) and surgical information (estimated blood loss, operative time, intraoperative complications, readmission and reoperation rates, presence of postoperative infection) were collected. Results The majority of patients were postmenopausal (58.91%), multiparous (mean parity = 2.49) and overweight (mean BMI = 27.71). Nearly 20% had previous prolapse surgery. The most common surgical procedure was laparoscopic supracervical hysterectomy (LSH) with sacrocervicopexy (59.26%), and the most common vaginal repair was of the posterior compartment (78.68%). The median operative time was 149 minutes (82-302), and the estimated blood loss was 100 mL (10-530). Five intra-operative complications, five readmissions and four reoperations were noted. Performance of a concomitant hysterectomy did not affect surgical or anatomical outcomes. Conclusion Combination laparoscopic/vaginal prolapse repair by two separate surgeons seems to be an efficient option for operative management.
authors: Minimally Invasive Gynecological Surgery Division, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.
authors: Luiz Gustavo Oliveira
authors: LG
authors: Brito
authors: Minimally Invasive Gynecological Surgery Division, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.
authors: Sarah Lauren
authors: SL
authors: Cohen
authors: Minimally Invasive Gynecological Surgery Division, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.
authors: Olga
authors: O
authors: Tusheva
authors: Boston Urogyn, Wellesley, Massachusetts, United States.
authors: Neeraj
authors: N
authors: Kohli
authors: Boston Urogyn, Wellesley, Massachusetts, United States.
authors: Abraham
authors: A
authors: Morse
authors: Minimally Invasive Gynecological Surgery Division, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.
authors: Emily Rose
authors: ER
authors: Goggins
authors: Minimally Invasive Gynecological Surgery Division, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.
authors: Jon Ivar
authors: JI
authors: Einarsson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014621:Vagina