Laparoscopic Endoscopic and Robotic Surgery最新文献

{"title":"Laparoscopic management of remnant gall bladder with stones: Lessons from a tertiary care centre's experience","authors":"Gilbert Samuel Jebakumar ,&nbsp;Jeevanandham Muthiah ,&nbsp;Loganathan Jayapal ,&nbsp;R. Santhosh Kumar ,&nbsp;Siddhesh Tasgaonkar ,&nbsp;K.S. Santhosh Anand ,&nbsp;J.K.A. Jameel ,&nbsp;Sudeepta Kumar Swain ,&nbsp;K.J. Raghunath ,&nbsp;Prasanna Kumar Reddy ,&nbsp;Tirupporur Govindaswamy Balachandar","doi":"10.1016/j.lers.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.lers.2024.02.004","url":null,"abstract":"<div><h3>Objective</h3><p>Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone disease. Despite its success, approximately 10% of patients may experience persistent biliary symptoms, leading to the post-cholecystectomy syndrome. A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this syndrome. The objective of this study was to shed light on the clinical manifestations, evaluation, therapeutic strategies, and outcomes associated with laparoscopic management of symptomatic remnant gallbladders.</p></div><div><h3>Methods</h3><p>This was a retrospective study, conducted over a five-year period (January 2017 to December 2022) at Apollo Hospitals in South India. All patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were included. The following data were collected: patient demographics, symptoms, preoperative investigations, intraoperative details and post operative outcomes.</p></div><div><h3>Results</h3><p>In total, 36 patients were included and analysed. The majority of patients were male (25, 69.4%), with a mean age of 50.7 ± 12.1 years. The most common presentation was pain in the upper abdomen or right upper quadrant region (24, 66.7%). The laparoscopic approach was attempted in all patients, with a success rate of 94.4%. Two patients required conversion to open surgery. Cholecystoenteric fistula to the colon was observed in one patient. Choledocholithiasis was observed in 7 patients (19.4%), and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients preoperatively.</p></div><div><h3>Conclusion</h3><p>Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and infection. Patients who have this clinical entity with symptoms require a redo or complete cholecystectomy, a complex procedure associated with certain risks. This study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder with cystic duct or bile duct stones.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 1","pages":"Pages 27-33"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000057/pdfft?md5=23b0760e83b6e8170dda363435505da5&pid=1-s2.0-S2468900924000057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to our wonderful peer reviewers and authors","authors":"Qingjie Zeng,&nbsp;Jin Wang","doi":"10.1016/j.lers.2023.12.001","DOIUrl":"https://doi.org/10.1016/j.lers.2023.12.001","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246890092300066X/pdfft?md5=2c4f46522569fe2600a515186e7a0c4d&pid=1-s2.0-S246890092300066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“A stitch in time”: Intraoperative diaphragmatic injury during laparoscopic nephrectomy - A case of immediate recognition and expert management","authors":"Prakash Gyandev Gondode,&nbsp;Sridhar Panaiyadiyan,&nbsp;Neha Garg,&nbsp;Sakshi Duggal","doi":"10.1016/j.lers.2024.02.002","DOIUrl":"10.1016/j.lers.2024.02.002","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 1","pages":"Pages 44-47"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000033/pdfft?md5=b1b7824aac946cdbd082d8c2aa2f6508&pid=1-s2.0-S2468900924000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139813114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of clinical subphenotypes of sepsis after laparoscopic surgery","authors":"Jie Yang ,&nbsp;Bo Zhang ,&nbsp;Chaomin Hu ,&nbsp;Xiaocong Jiang ,&nbsp;Pengfei Shui ,&nbsp;Jiajie Huang ,&nbsp;Yucai Hong ,&nbsp;Hongying Ni ,&nbsp;Zhongheng Zhang","doi":"10.1016/j.lers.2024.02.001","DOIUrl":"10.1016/j.lers.2024.02.001","url":null,"abstract":"<div><h3>Objective</h3><p>Some patients exhibit septic symptoms following laparoscopic surgery, leading to a poor prognosis. Effective clinical subphenotyping is critical for guiding tailored therapeutic strategies in these cases. By identifying predisposing factors for postoperative sepsis, clinicians can implement targeted interventions, potentially improving outcomes. This study outlines a workflow for the subphenotype methodology in the context of laparoscopic surgery, along with its practical application.</p></div><div><h3>Methods</h3><p>This study utilized data routinely available in clinical case systems, enhancing the applicability of our findings. The data included vital signs, such as respiratory rate, and laboratory measures, such as blood sodium levels. The process of categorizing clinical routine data involved technical complexities. A correlation heatmap was used to visually depict the relationships between variables. Ordering points were used to identify the clustering structure and combined with Consensus K clustering methods to determine the optimal categorization.</p></div><div><h3>Results</h3><p>Our study highlighted the intricacies of identifying clinical subphenotypes following laparoscopic surgery, and could thus serve as a valuable resource for clinicians and researchers seeking to explore disease heterogeneity in clinical settings. By simplifying complex methodologies, we aimed to bridge the gap between technical expertise and clinical application, fostering an environment where professional medical knowledge is effectively utilized in subphenotyping research.</p></div><div><h3>Conclusion</h3><p>This tutorial could primarily serve as a guide for beginners. A variety of clustering approaches were explored, and each step in the process contributed to a comprehensive understanding of clinical subphenotypes.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 1","pages":"Pages 16-26"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000021/pdfft?md5=4e9536b4e1a3dd16fe3ee661f980f773&pid=1-s2.0-S2468900924000021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139873447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of a risk-prediction model for anastomotic leakage after radical gastrectomy: A cohort study in China","authors":"Jinrui Wang ,&nbsp;Xiaolin Liu ,&nbsp;Hongying Pan ,&nbsp;Yihong Xu ,&nbsp;Mizhi Wu ,&nbsp;Xiuping Li ,&nbsp;Yang Gao ,&nbsp;Meijuan Wang ,&nbsp;Mengya Yan","doi":"10.1016/j.lers.2024.02.003","DOIUrl":"10.1016/j.lers.2024.02.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Anastomotic leakage (AL) stands out as a prevalent and severe complication following gastric cancer surgery. It frequently precipitates additional serious complications, significantly influencing the overall survival time of patients. This study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric cancer.</p></div><div><h3>Methods</h3><p>This study included a derivation cohort and validation cohort. The derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, from January 1, 2015 to December 31, 2020. An evidence-based predictor questionnaire was crafted through extensive literature review and panel discussions. Based on the questionnaire, inpatient data were collected to form a model-derivation cohort. This cohort underwent both univariate and multivariate analyses to identify factors associated with AL events, and a logistic regression model with stepwise regression was developed. A 5-fold cross-validation ensured model reliability. The validation cohort included patients from August 1, 2021 to December 31, 2021 at the same hospital. Using the same imputation method, we organized the validation-queue data. We then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation queue. We compared the predictions with the actual occurrence, and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve (AUROC), Brier score, and calibration curve.</p></div><div><h3>Results</h3><p>The derivation cohort included 1377 patients, and the validation cohort included 131 patients. The independent predictors of AL after radical gastrectomy included age ≥65 y, preoperative albumin &lt;35 g/L, resection extent, operative time ≥240 min, and intraoperative blood loss ≥90 mL. The predictive model exhibited a solid AUROC of 0.750 (95% CI: 0.694–0.806; <em>p</em> &lt; 0.001) with a Brier score of 0.049. The 5-fold cross-validation confirmed these findings with a calibrated C-index of 0.749 and an average Brier score of 0.052. External validation showed an AUROC of 0.723 (95% CI: 0.564–0.882; <em>p</em> = 0.006) and a Brier score of 0.055, confirming reliability in different clinical settings.</p></div><div><h3>Conclusions</h3><p>We successfully developed a risk-prediction model for AL following radical gastrectomy. This tool will aid healthcare professionals in anticipating AL, potentially reducing unnecessary interventions.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 1","pages":"Pages 34-43"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000045/pdfft?md5=e4652bf96f3901b6936fa391845c8c3c&pid=1-s2.0-S2468900924000045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139883877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cholecystectomy on the risk of colorectal cancer: A systematic review and meta-analysis","authors":"Zhuoneng Chen ,&nbsp;Chaohui Yu ,&nbsp;Zheyong Li","doi":"10.1016/j.lers.2023.11.003","DOIUrl":"10.1016/j.lers.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>Some studies have found that cholecystectomy may increase the risk of colorectal cancer (CRC), while others have reached inconsistent conclusions. We thus performed a systematic review and meta-analysis to assess the incidence rate of CRC after cholecystectomy for patients with gallstones or gallbladder diseases, and whether the geographical location of the patients affected the results.</p></div><div><h3>Methods</h3><p>We systematically searched PubMed, Embase, and Cochrane for studies reporting changes in the incidence rate of CRC after cholecystectomy published before January 12, 2023. Our main endpoint was the occurrence of CRC. Data were extracted and pooled, and the relative risk (RR) and 95% confidence interval (CI) were calculated. We assessed pooled data using a random-effects model.</p></div><div><h3>Results</h3><p>In total, 477 articles were identified, and 6 articles were eligible, including 7 studies that included 797,917 participants. Overall, the summarized research results showed that the risk of CRC was reduced in patients with gallbladder diseases who underwent cholecystectomy (RR: 0.80, 95% CI: 0.65 to 0.99, <em>p</em> = 0.040; <em>I</em>² = 85.0%). In the subgroup analysis based on different geographical locations, cholecystectomy was not associated with the risk of CRC in the Western population (RR: 0.90, 95% CI: 0.65 to 1.25, <em>p</em> = 0.522; <em>I</em>² = 86.5%), but there was a negative correlation between cholecystectomy and the risk of CRC (RR: 0.66, 95% CI: 0.60 to 0.73, <em>p</em> = 0.000) in the Chinese population.</p></div><div><h3>Conclusions</h3><p>Our findings support that for patients with gallstones or gallbladder diseases, the incidence of CRC after cholecystectomy is lower than that of patients who do not undergo cholecystectomy.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 4","pages":"Pages 134-141"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900923000634/pdfft?md5=93bf4ba1bc11f4431ac83d03acde1913&pid=1-s2.0-S2468900923000634-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135670483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes of single-incision compared to multi-port laparoscopic gastrectomy for gastric cancer: A meta-analysis of randomized controlled trials","authors":"Sameh Hany Emile ,&nbsp;Samer Hani Barsom","doi":"10.1016/j.lers.2023.10.001","DOIUrl":"10.1016/j.lers.2023.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>Single-incision laparoscopic surgery has emerged as a safe and less invasive approach to conventional multi-port laparoscopy. The present meta-analysis aimed to assess the collective outcomes of single-incision laparoscopic gastrectomy (SILG) compared to multi-port laparoscopic gastrectomy (MLG) for gastric cancer.</p></div><div><h3>Methods</h3><p>A PRISMA-compliant systematic review of randomized controlled trials (RCTs) that compared SILG and MLG for gastric cancer in PubMed and Scopus through January 2023 was conducted. The main outcomes of the review were complications, postoperative pain, conversion to open surgery, hospital stay, and recovery.</p></div><div><h3>Results</h3><p>Three RCTs including 301 patients (61.8% male) were included. A total of 151 patients underwent SILG, and 150 underwent MLG. SILG was associated with a shorter operative time (WMD = −16.39, 95% CI: −27.38 to −5.40, <em>p</em> = 0.003; <em>I</em>² = 0%) and lower pain scores at postoperative day 3 (WMD = −1.18, 95% CI: −2.27 to −0.091, <em>p</em> = 0.033; <em>I</em>² = 99%) than MLG. There were no statistically significant differences between the two groups in estimated blood loss (WMD = –16.95, 95% CI: −35.84 to 1.95, <em>p</em> = 0.078; <em>I</em>² = 82%), complications (OR = 0.71, 95% CI: 0.36 to 1.42, <em>p</em> = 0.337; <em>I</em>² = 0%), conversion to open surgery (OR = 0.33, 95% CI: 0.01 to 8.38, <em>p</em> = 0.504), hospital stay (WMD = 0.72, 95% CI: −0.92 to 2.36, <em>p</em> = 0.056; <em>I</em>² = 84%), time to first flatus (WMD = 0.06, 95% CI: −0.14 to 0.26, <em>p</em> = 0.566; <em>I</em>² = 0%), time to first defecation (WMD = −0.14, 95% CI: −0.46 to 0.18, <em>p</em> = 0.392; <em>I</em>² = 0%), or time to first oral intake (WMD = 0.37, 95% CI: −0.75 to 1.49, <em>p</em> = 0.520; <em>I</em>² = 94%).</p></div><div><h3>Conclusions</h3><p>SILG is associated with shorter operative times and less early postoperative pain than MLG. The odds of complications, blood loss, hospital stay, and gastrointestinal recovery were similar between the two procedures.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 4","pages":"Pages 127-133"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900923000592/pdfft?md5=68940e521b04a623c409130687e14b8f&pid=1-s2.0-S2468900923000592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135762532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A degradable intestinal diversion device","authors":"Qingjie Zeng,&nbsp;Jin Wang","doi":"10.1016/j.lers.2023.09.001","DOIUrl":"10.1016/j.lers.2023.09.001","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 4","pages":"Pages 167-170"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900923000452/pdfft?md5=ee0399bbe6f0e8ccff0431e975385fcf&pid=1-s2.0-S2468900923000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of robotic-assisted spinal surgery: A single-center retrospective study","authors":"Sorayouth Chumnanvej ,&nbsp;Krish Ariyaprakai ,&nbsp;Branesh M. Pillai ,&nbsp;Jackrit Suthakorn ,&nbsp;Sharvesh Gurusamy ,&nbsp;Siriluk Chumnanvej","doi":"10.1016/j.lers.2023.11.004","DOIUrl":"10.1016/j.lers.2023.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>Robotic-assisted spine surgeries (RASS) have been shown to enhance precision, reduce operative time, prevent complications, facilitate minimally invasive spinal surgery, and decrease revision surgery rates, leading to improved patient outcomes. This study aimed to compare the cost-effectiveness of RASS and non-robotic-assisted surgery for degenerative spine disease at a single center.</p></div><div><h3>Methods</h3><p>This retrospective study, including 122 patients, was conducted at a single center from March 2015 to February 2022. Patients who underwent robot-assisted surgery were assigned to the robot group, and patients who underwent non-robotic-assisted surgery were assigned to the non-robot group. Various data, including demographic information, surgical details, outcomes, and cost-effectiveness, were collected for both groups. The cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), and subgroup analysis was conducted for patients with 1 or 2 levels of spinal instrumentation. The analysis was performed using STATA SE version 15 and TreeAge Pro 2020, with Monte Carlo simulations for the cost-effectiveness acceptability curve.</p></div><div><h3>Results</h3><p>The overall ICER was $22,572, but it decreased to $16,980 when considering cases with only 1 or 2 levels of instrumentation. RASS is deemed cost-effective when the willingness to pay is $3000–$4000 if less than 2 levels of the spine are instrumented.</p></div><div><h3>Conclusions</h3><p>The cost-effectiveness of robotic assistance becomes apparent when there is a reduced need for open surgeries, leading to decreased revision rates caused by complications such as misplaced screws or infections. Therefore, it is advisable to allocate healthcare budget resources to spine robots, as RASS proves to be cost-effective, particularly when only two or fewer spinal levels require instrumentation.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 4","pages":"Pages 147-153"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900923000646/pdfft?md5=ebcbb101d0bc0c1a36ee22aed7fb3459&pid=1-s2.0-S2468900923000646-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135715195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with posterior approach for a pelvic organ prolapse: A retrospective study of 124 cases","authors":"Yunshan Zhu ,&nbsp;Xiao Zhang ,&nbsp;Danxia Chen ,&nbsp;Guangxiao Li ,&nbsp;Shanliang Shang ,&nbsp;Jianqiong Li ,&nbsp;Jianhua Yang","doi":"10.1016/j.lers.2023.11.005","DOIUrl":"https://doi.org/10.1016/j.lers.2023.11.005","url":null,"abstract":"<div><h3>Objective</h3><p>Pelvic organ prolapse (POP) is a common gynecological disease in middle-aged and older women that seriously affects patients' physical health and quality of life, increases the financial burden for patients, and becomes a major public health concern. The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for patients with severe POP.</p></div><div><h3>Methods</h3><p>Patients with severe POP quantitation stage III–IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at the Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine between September 2016 and December 2020 were enrolled in this study. The results and complications were recorded. Data were retrospectively reviewed.</p></div><div><h3>Results</h3><p>In total, 124 patients were analyzed. Patients were followed up for 32.27 ± 12.90 months. The objective cure rate for patients who underwent hysterectomy was 91.7% (100/109), with 7 (6.4%) patients had anterior vaginal wall prolapse and 2 (1.8%) patients had posterior vaginal wall prolapse. The objective cure rate for patients who retained uterus was 66.7% (10/15). All 5 patients with recurrence had uterine prolapse, and 3 (20.0%) of them also had anterior vaginal wall prolapse.</p></div><div><h3>Conclusions</h3><p>Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe, minimally invasive, and effective method for patients with severe POP. Long-term follow-up is needed to confirm the clinical effects.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 4","pages":"Pages 154-159"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900923000658/pdfft?md5=2d8ff7ecaf4f8f82677faab1990ece7d&pid=1-s2.0-S2468900923000658-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}