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. 2022 Jul 29:9:931691.
doi: 10.3389/fsurg.2022.931691. eCollection 2022.

A preliminary clinical report of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse

Zhenyue Qin  1 , Zhiyong Dong  2 , Huimin Tang  2 , Shoufeng Zhang  1 , Huihui Wang  1 , Mingyue Bao  1 , Weiwei Wei  2 , Ruxia Shi  2 , Jiming Chen  2 , Bairong Xia  3
Affiliations

A preliminary clinical report of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse

Zhenyue Qin et al. Front Surg. .

Abstract

Objective: To study the efficacy and safety of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse.

Design: Patients were selected into this study on a voluntary basis to evaluate the short-term efficacy of this surgery by comparing the OP-Q scores before the operation, three months after the operation, and six months after the operation.

Setting and patients: Evaluate the clinical efficacy and safety by a retrospective analysis of the clinical data of the 18 patients with POP-Q grade III-IV pelvic organ prolapse treated by the Department of Gynecology of Nanjing Medical University Affiliated Changzhou No.2 People's Hospital from April 2020 to November 2020, and their post-operation follow-ups.

Interventions: Patients with postoperative follow-ups found no obvious relapse without intervention measures.

Measurements and main results: The transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation was performed successfully, and the anterior and posterior walls of vagina and/or trans-vaginal hysterectomy were repaired as appropriate. Except the total vaginal length (TVL), the P values of numerical analysis for all points before, three months after, and six months after the operation were all <0.05, being statistically significant.

Conclusion: This method is effective in the treatment of moderate and severe pelvic organ prolapse with few complications, but more cases and longer-term follow-up data are needed to determine the long-term effect of this procedure. For the selection of puncture sites, more anatomical data are needed to get more accurate result.

Keywords: V-NOTES; pelvic organ prolapse (POP); sacrospinous ligament suspension; surgical research; transvaginal single-port laparoscopy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Surgical procedures. (A) Installing a specialized port for transvaginal single hole; (B) Separate tissue; (C) Expose the sacrospinous ligament at the sacrococcygeal attachment; (D) Expose the sciatic spine; (E) Expose the sacrospinous ligament and iliococcygeus; (F) Ethibond Excel W6937 non-absorbable suture to suture the sacral spine ligament; (G) Pull the suture to judge the tension; (H) Tie a knot with the suture.
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