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International Urogynecology Journal

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01.09.2009 | Original Article

Implementation of laparoscopic sacrocolpopexy—a single centre’s experience

verfasst von: Filip Claerhout, Jan Paul Roovers, Paul Lewi, Jasper Verguts, Dirk De Ridder, Jan Deprest

Erschienen in: International Urogynecology Journal | Ausgabe 9/2009

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Abstract

Introduction and hypothesis

The aim of this study was to describe the learning curve of a single surgeon to achieve the ability to perform a complication-free and anatomically successful laparoscopic sacrocolpopexy (LSC).

Methods

All patients, from the first LSC onwards (1996) were included. Outcome measures were operation time, number of laparotomies, complications and anatomical failures within 3 months. Learning curves were generated using moving average method (MOA) and cumulative sum (CUSUM) analysis to assess changes in respectively operation time and failures (laparotomy, complication or anatomical failure).

Results

Of the 206 patients, 83% were completed by laparoscopy. The intra-operative and major respectively minor post-operative complication rates were 2.4% (n = 5), 4.4% (n = 9) and 12.6% (n = 26). CUSUM analysis showed adequate learning after 60 cases. MOA showed that operation time declined rapidly during the first 30 procedures reaching a steady state (175 min) after 90 cases. Complications remained unchanged throughout the series.

Conclusions

LSC was associated with a low complication rate but a long learning curve.

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Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S (2007). Surgical management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD004014. doi:10.1002/14651858.CD004014.pub3.

Garry R, Fountain J, Mason S et al (2004) The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 328:129–136PubMedCrossRef

Cosson M, Rajabally R, Bogaert E, Querleu D, Crépin G (2002) Laparoscopic sacrocolpopexy, hysterectomy and Burch colposuspension: feasibility and short-term complications of 77 procedures. J Soc Lap Surg 6:115–119

Antiphon P, Elard S, Benyoussef A et al (2004) Laparoscopic promontory sacral colpopexy: is the posterior recto-vaginal mesh mandatory. Eur Urol 45:655–661PubMedCrossRef

Rozet F, Mandron E, Arroyo C et al (2005) Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases. Eur Urol 47:230–236PubMedCrossRef

Paraiso MF, Walters MD, Rackley RR, Melek S, Hugney C (2005) Laparoscopic and abdominal sacral colpopexies: a comparative cohort study. Am J Obstet Gynecol 192(5):752–758CrossRef

Rivoire C, Botchorishvili R, Canis M et al (2007) Complete laparoscopic treatment of genital prolapse with meshes including vaginal promontofixation and anterior repair: a series of 138 patients. J Minim Invasive Gynecol 14(6):712–718PubMedCrossRef

Agarwala N, Hasiak N, Shade M (2007) Laparoscopic sacral colpopexy with Gynemesh as graft material—experience and results. J Minim Invasive Gynecol 14(5):577–583PubMedCrossRef

Cook JR, Seman EI, O’Shea RT, 2 (2004) Laparoscopic treatment of enterocele: a 3-year evaluation. Aust N Z J Obstet Gynaecol 44:107–110PubMedCrossRef

10.

Gadonneix P, Ercoli A, Salet-Lizée D et al (2004) Laparoscopic sacrocolpopexy with two separate meshes along the anterior and posterior vaginal walls for multicompartment pelvic organ prolapse. J Am Assoc Gynecol Laparosc 11:29–35PubMedCrossRef

11.

Ross JW, Preston M (2005) Laparoscopic sacrocolpopexy for severe vaginal vault prolapse: five year outcome. J Minim Invasive Gynecol 12(3):221–226PubMedCrossRef

12.

Ramsay CR, Grant AM, Wallace SA, Garthwaite PH, Monk AF, Russell IT (2001) Statistical assessment of the learning curves of health technologies. Health Technol Assess 5(12):1–79PubMed

13.

Choi DH, Jeong WK, Lim SW et al (2008) Learning curves for laparoscopic sigmoidectomy used to manage curable sigmoid colon cancer: single-institute, three-surgeon experience. Surg Endosc . doi:10.1007/s00464-008-9753-y

14.

Deprest JA, Munro MG, Koninckx PR (1995) Review on laparoscopic hysterectomy. Zentralbl Gynakol 117(12):641–651PubMed

15.

Froeling F, Deprest J, Ankum W, Mendels E, Meijer D, Bannenberg J (2000) Controlled balloon dilatation for laparoscopic extraperitoneal bladder neck suspension in patients with previous abdominal surgery. J Laparo-end Adv Surg Tech 10:27–30CrossRef

16.

Claerhout F, De Ridder D, Roovers JP et al (2008) Medium term anatomical and functional results of laparoscopic sacrocolpopexy beyond the learning curve. Eur Urol . doi:10.1016/j.eururo.2008.12.008 PubMed

17.

Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:15–21CrossRef

18.

D’hoore A, Cadoni R, Penninckx F (2004) Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 91(11):1500–1505PubMedCrossRef

19.

Altgassen C, Michels W, Schneider A (2004) Learning laparoscopic-assisted hysterectomy. Obstet Gynecol 104:308–313PubMed

20.

Bolsin S, Colson M (2000) The use of the Cusum technique in the assessment of trainee competence in new procedures. Int J Qual Health Care; 12:433–438PubMedCrossRef

21.

Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM, Pelvic Floor Disorders Network (2004) Abdominal sacrocolpopexy : a comprehensive review. Obstet Gynecol 104:805–823PubMed

22.

Culligan PJ, Murphy M, Blackwell L, Hammons G, Graham C, Heit MH (2002) Long-term success of abdominal sacral colpopexy using synthetic mesh. Am J Obstet Gynecol 187(6):1473–1480PubMedCrossRef

23.

Cushieri A (1995) Whither minimal access surgery: tribulations and expectations. Am J Surg 169(1):9–19CrossRef

24.

Darzi A, Smith S, Taffinder N (1999) Assessing operative skill. Needs to become more objective. BMJ 318(7188):887–888PubMed

25.

Chen W, Sailhamer E, Berger DL, Rattner DW (2007) Operative time is a poor surrogate for the learning curve in laparoscopic colorectal surgery. Surg Endosc 21(2):238–243PubMedCrossRef

26.

Lowenstein L, FitzGerald MP, Kenton K et al (2008) Patient-selected goals: the fourth dimension in assessment of pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 19(1):81–84PubMed

27.

Marusch F, Gastinger I, Schneider C et al (2001) Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results. Surg Endosc 15(2):116–120PubMedCrossRef

28.

Boukerrou M, Orazi G, Nayama M, Boodhun R, Crépin G, Cosson M (2003) Promontofixation procedure: use of non-absorbable sutures or tackers? J Gynecol Obstet Biol Reprod 32:524–528

29.

Perino A, Cucinella G, Venezia R, Castelli A, Cittadini E (1999) Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study. Hum Reprod 14(12):2996–2999PubMedCrossRef

30.

Gill J, Booth MI, Stratford J, Dehn TC (2007) The extended learning curve for laparoscopic fundoplication: a cohort analysis of 400 consecutive cases. J Gastrointest Surg 11(4):487–492PubMedCrossRef

Titel: Implementation of laparoscopic sacrocolpopexy—a single centre’s experience
verfasst von: Filip Claerhout
Jan Paul Roovers
Paul Lewi
Jasper Verguts
Dirk De Ridder
Jan Deprest
Publikationsdatum: 01.09.2009
Verlag: Springer-Verlag
Erschienen in: International Urogynecology Journal / Ausgabe 9/2009
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-0914-x

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Implementation of laparoscopic sacrocolpopexy—a single centre’s experience

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Methods

Results

Conclusions

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