Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Our aim was to determine the intraoperative feasibility and complication rate of laparoscopic sacrocolpopexy (LSC) in overweight and obese women compared with women of normal weight.
This was a retrospective observational cohort study (Canadian Task Force classification II-2) conducted at a tertiary urogyaenocology unit evaluating 119 women who underwent LSC between March 2005 and January 2013.
Body mass index (BMI) was classified as normal (22.89 ± 1.55), overweight (27.12 ± 1.40) and obese (33.47 ± 3.26) according to the World Health Organisation (WHO) classification. There was no difference in intraoperative complication rates for bladder, bowel, ureteric or vascular injury; haemorrhage; conversion to laparotomy; or anaesthetic complications for normal weight, overweight or obese women. Similarly there was no difference in operating time, duration of anaesthetic or hospital stay between BMI class (p = 0.070, p = 0.464, p = 0.898, respectively) postoperative or mesh complication rates. At 6-months’ follow-up, there was no difference in Patient Global Impression of Improvement scale (PGI-I) (defined as very much better or much better) between normal weight, overweight and obese women (76.9, 72 and 65.4%, p = .669) or objective cure using the Pelvic Organ Prolapse Quantification (POP-Q) examination (p = 0.402).
LSC is feasible, with equivalent intraoperative complication rates for normal weight, overweight and obese women when performed by experienced laparoscopic urogynaecologists. Given the benefits of a laparoscopic approach in obese women, the authors suggest they should be offered LSC as an option to treat vault prolapse when surgical management is being considered.
Marchionni M, Bracco G, Checcucci V, Carabaneanu A, Coccia E, Mecacci F, et al. True incidence of vaginal vault prolapse. Thirteen years of experience. J Reprod Med. 1999;44(8):679–84.
Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, et al. Pelvic organ support study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806. CrossRef
Whiteside JL, Weber AM. Meyn L a., Walters MD. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol. 2004;191(5):1533–8. CrossRef
Kelly T, Yang W, Chen C, Reynolds K. Global burden of obesity in 2005 and projections to 2030. Int J. 2008.
Coolen AWM, Van Oudheusden AMJ, Van Eijndhoven HWF, Van Der Heijden TPF, Stokmans RA, Mol BWJ, et al. A comparison of complications between open abdominal Sacrocolpopexy and laparoscopic Sacrocolpopexy for the treatment of vault prolapse. Obstet Gynecol Int. 2013;2013.
Freeman R, Pantazis K, Thomson A. A randomised controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Int Urogynecol J. 2013.
Naqa A El, Guerrero K, Fattah MA. Posthysterectomy vaginal vault prolapse. RCOG/BSUG Joint Guideline. London; 2015.
Thubert T, Naveau A, Letohic A, Villefranque V, Benifla JL, Deffieux X. Outcomes and feasibility of laparoscopic sacrocolpopexy among obese versus nonobese women. Int J Gynecol Obstet. 2013;120(1):49–52. CrossRef
World Health Organization (WHO). Body mass index - BMI [Internet]. 2016 [cited 2016 Aug 5]. p. 1–2. Available from.
Haylen B, Freeman RM, Swift S, Cosson M, Davila W, Deprest J, et al. An Internation Urogynaecological association (IUGA)/ international continence society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic Flo. Neurourol Urodyn. 2011;30:2–12. CrossRef
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010 May;29(1):4–20.
Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(5):523–8. CrossRef
Turner L, Lavelle E, Lowder JL, Jonathan P. The impact of obesity on intraoperative complications and prolapse recurrence after minimally invasive Sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2016;22(5):317–23. CrossRef
Anger JT, Mueller ER, Tarnay C, Smith B, Stroupe K, Rosenman A, et al. Robotic compared with laparoscopic Sacrocolpopexy. Obstet Gynecol. 2014;123(1):5–12. CrossRef
Paraiso MFR, Jelovsek JE, Frick A. Laparoscopic compared with robotic Sacrocolpopexy for vaginal prolapse. Obstet Gynecol. 2011;118(5):1005–13. CrossRef
Kissane L, Calixte R, Grigorescu B, Finamore P, Vintzileos A. Impact of obesity on robotic-assisted Sacrocolpopexy. J Minim Invasive Gynecol Elsevier Inc. 2017;24(1):36–40. CrossRef
Halder GE, Salemi JL, Hart S, Mikhail E. Association between obesity and perioperative morbidity in open versus laparoscopic Sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2017;23(2):146–50. CrossRef
Dällenbach P, Kaelin-Gambirasio I, Dubuisson J-B, Boulvain M. Risk factors for pelvic organ prolapse repair after hysterectomy. Obstet Gynecol. 2007;110(3):625–32. CrossRef
- Laparoscopic sacrocolpopexy posthysterectomy: intraoperative feasibility and safety in obese women compared with women of normal weight
- Springer International Publishing
International Urogynecology Journal
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II