Device Selection Contributes to Operative Time Reduction in Laparoscopic Sacrocolpopexy.

Abstract

Objectives: The standard laparoscopic sacrocolpopexy (LSC) technique involves several suture fixation sites, which can prolong the operative time. This study aimed to investigate the extent to which the operative time could be shortened using devices such as tackers in sites where suture manipulation could be omitted.

Materials and methods: The study enrolled 82 patients who underwent LSC at our hospital between May 2016 and May 2022. The median operative time was 3.2 h (1.78-6.5 h). Changes in symptoms before and after surgery were measured using several questionnaires and 60-min pad weight testing among patient groups based on the device used.

Results: Among the preoperative factors, no factors were found to be significantly correlated with the operative time (≥3.2 h or <3.2 h). As intraoperative factors, significant associations were found between the number of tackers used on the posterior vaginal wall, anterior vaginal wall, and cervix (0-3 locations), whether a device was used in mesh retroperitonealization, whether the first needle used to fix the anterior longitudinal ligament was successful, whether adhesion dissection was performed, and the type of sealing device. Among these factors, the use of tackers on the posterior wall, anterior wall, and cervix and the use of a device in mesh retroperitonealization were significantly associated with the operative time.

Conclusion: The use of easy-to-operate devices appeared to contribute to a shorter operative time in LSC.