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Case Reports
. 2023 Mar 29:10:1066622.
doi: 10.3389/fsurg.2023.1066622. eCollection 2023.

Case report: Transvaginal single-port extraperitoneal laparoscopic sacrospinous ligament fixation for apical prolapse: A single-center case series

Ye Liu  1   2 , Chao Wang  1   2 , Xianjing Wang  1   2 , Rongrong Yan  1   2 , Lei Chu  1   2 , Xinliang Chen  1   2
Affiliations
Case Reports

Case report: Transvaginal single-port extraperitoneal laparoscopic sacrospinous ligament fixation for apical prolapse: A single-center case series

Ye Liu et al. Front Surg. .

Abstract

Background: Sacrospinous ligament fixation (SSLF) is a minimally invasive and effective procedure for the treatment of apical prolapse. Because intraoperative exposure of the sacrospinous ligament is difficult, SSLF is difficult. The aim of our article is to determine the safety and feasibility of single-port extraperitoneal laparoscopic SSLF for apical prolapse.

Methods: This single-center, single-surgeon case series study included 9 patients with pelvic organ prolapse quantification (POP-Q) III or IV apical prolapse who underwent single-port laparoscopic SSLF. Additionally, transobturator tension-free vaginal tap (TVT-O) was performed in 2 patients, and anterior pelvic mesh reconstruction was performed in 1 patient.

Results: The operative time ranged from 75 to 105 (mean, 88.9 ± 10.2) min, and blood loss ranged from 25 to 100 (mean, 43.3 ± 22.6) ml. No serious operative complications, blood transfusions, visceral injuries, or postoperative gluteal pain were reported for these patients. After 2-4 months of follow-up, no recurrence of POP, gluteal pain, urinary retention/incontinence, or other complications was observed.

Conclusion: Transvaginal single-port SSLF is a safe, effective, and easy-to-master operation for apical prolapse.

Keywords: POP; sacrospinous ligament fixation; single-port laparoscopy; transvaginal; video.

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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
Placement of single-port devices. The laparoscopic incision protector was placed inside the posterior vaginal wall incision and made contact with the tissues..
Figure 2
Figure 2
Sacrospinous ligament exposure. An ultrasonic scalpel was used to laparoscopically separate the loose tissues next to the rectum until the sacrospinous ligament, the adjacent piriformis, and iliococcygeal muscles were fully exposed.
Figure 3
Figure 3
Sacrospinous ligament suturing. The right sacrospinous ligament was sutured with a nonabsorbable suture using a circular needle (O1/2 10 × 20) approximately 2 cm from the ischial spine at a depth of ≤0.3 cm.
See this image and copyright information in PMC

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