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. 2024 Aug;38(8):4344-4352.
doi: 10.1007/s00464-024-10917-5. Epub 2024 Jun 14.

Role of lateral suspension for the treatment of pelvic organ prolapse: a Delphi survey of expert panel

Tommaso Simoncini  1 , Andrea Panattoni  2 , Tina Cadenbach-Blome  3 , Nicola Caiazzo  4 , Maribel Calero García  5 , Marta Caretto  6 , Fu Chun  7 , Eric Francescangeli  8 , Giorgia Gaia  9 , Andrea Giannini  6 , Lucas Hegenscheid  10 , Stefano Luisi  6 , Paolo Mannella  6 , Liliana Mereu  11 , Maria Magdalena Montt-Guevara  6 , Isabel Ñiguez  12 , Ratiba Ritter  13 , Eleonora Russo  2 , Maria Luisa Sanchez Ferrer  12 , Ayman Tammaa  14 , Bernhard Uhl  15 , Bea Wiedemann  13 , Maciej Wilczak  16 , Friedrich Pauli  17 , Jean Dubuisson  18
Affiliations

Role of lateral suspension for the treatment of pelvic organ prolapse: a Delphi survey of expert panel

Tommaso Simoncini et al. Surg Endosc. 2024 Aug.

Abstract

Introduction and hypothesis: Lateral suspension is an abdominal prosthetic surgical procedure used to correct apical prolapse. The procedure involves the placement of a T-shaped mesh on the anterior vaginal wall and on the isthmus or uterine cervix that is suspended laterally and posteriorly to the abdominal wall. Since its description in the late 90s, modifications of the technique have been described. So far, no consensus on the correct indications, safety, advantages, and disadvantages of this emerging procedure has been reached.

Methods: A modified Delphi process was used to build consensus within a group of 21 international surgeons who are experts in the performance of laparoscopic lateral suspension (LLS). The process was held with a first online round, where the experts expressed their level of agreement on 64 statements on indications, technical features, and other aspects of LLS. A subsequent re-discussion of statements where a threshold of agreement was not reached was held in presence.

Results: The Delphi process allowed the identification of several aspects of LLS that represented areas of agreement by the experts. The experts agreed that LLS is a safe and effective technique to correct apical and anterior prolapse. The experts highlighted several key technical aspects of the procedure, including clinical indications and surgical steps.

Conclusions: This Delphi consensus provides valuable guidance and criteria for the use of LLS in the treatment of pelvic organ prolapse, based on expert opinion by large volume surgeons' experts in the performance of this innovative procedure.

Keywords: Delphi consensus; Laparoscopic lateral suspension; Pelvic floor reconstructive surgery; Pelvic organ prolapse; Sacrocolpopexy.

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Conflict of interest statement

Tommaso Simoncini has received consulting fees from Abbott, Astellas, Gedeon Richter, Mitsubishi Tanabe, Sojournix, Estetra, Mithra, Actavis, Medtronic, Shionogi, and Applied Medical and has received speakers’ honoraria from Shionogi, Gedeon Richter, Intuitive Surgical, Applied Medical, and Theramex. Ratiba Ritter has received consulting contract with PFM ag and TCB, Tina Cadenbach-Blome has received fees from A.M.I, Gedeon Richter, Gynesonics, Pfm medical ag, Rudolph medical, Theramex. Andrea Panattoni, Nicola Caiazzo, Maribel Calero García, Marta Caretto, Fu Chun, Eric Francescangeli, Giorgia Gaia, Andrea Giannini, Lucas Hegenscheid, Stefano Luisi, Paolo Mannella, Liliana Mereu, Maria Magdalena Montt-Guevara, Isabel Ñiguez, Maria Luisa Sanchez Ferrer, Ayman Tammaa, Eleonora Russo, Bernhard Uhl, Bea Wiedemann, Maciej Wilczak, Friedrich Pauli, and Jean Dubuisson have no conflicts of interest or financial ties to disclose.

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