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Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard?
Nowadays, the gold standard to treat apical pelvic organ prolapse (POP) is laparoscopic sacrocolpopexy (LSCP). However, LSCP is a difficult procedure associated with rare but potentially severe complications. Promontory dissection may expose to potential life-threatening intraoperative vascular inju...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406280/ https://www.ncbi.nlm.nih.gov/pubmed/36034345 http://dx.doi.org/10.3389/fsurg.2022.898392 |
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author | Dällenbach, Patrick |
author_facet | Dällenbach, Patrick |
author_sort | Dällenbach, Patrick |
collection | PubMed |
description | Nowadays, the gold standard to treat apical pelvic organ prolapse (POP) is laparoscopic sacrocolpopexy (LSCP). However, LSCP is a difficult procedure associated with rare but potentially severe complications. Promontory dissection may expose to potential life-threatening intraoperative vascular injuries, and sacral roots or hypogastric nerve damage. There are also a few case reports of spondylodiscitis with consecutive lumbar vertebra bone erosion. Laparoscopic lateral suspension (LLS) with mesh is an alternative technique for apical POP repair. It lowers perioperative risks by avoiding sacral promontory preparation. Recent studies show similar anatomical and functional outcomes to LSCP, with the advantage of better preserving the vaginal axis. Moreover, LLS is well suited for hysteropexy which is important as an increasing number of women prefer uterine preservation during POP surgery. In this article, we discuss both techniques, and we share our opinion on a novel perspective in the treatment of apical POP with uterine preservation. |
format | Online Article Text |
id | pubmed-9406280 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94062802022-08-26 Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? Dällenbach, Patrick Front Surg Surgery Nowadays, the gold standard to treat apical pelvic organ prolapse (POP) is laparoscopic sacrocolpopexy (LSCP). However, LSCP is a difficult procedure associated with rare but potentially severe complications. Promontory dissection may expose to potential life-threatening intraoperative vascular injuries, and sacral roots or hypogastric nerve damage. There are also a few case reports of spondylodiscitis with consecutive lumbar vertebra bone erosion. Laparoscopic lateral suspension (LLS) with mesh is an alternative technique for apical POP repair. It lowers perioperative risks by avoiding sacral promontory preparation. Recent studies show similar anatomical and functional outcomes to LSCP, with the advantage of better preserving the vaginal axis. Moreover, LLS is well suited for hysteropexy which is important as an increasing number of women prefer uterine preservation during POP surgery. In this article, we discuss both techniques, and we share our opinion on a novel perspective in the treatment of apical POP with uterine preservation. Frontiers Media S.A. 2022-05-12 /pmc/articles/PMC9406280/ /pubmed/36034345 http://dx.doi.org/10.3389/fsurg.2022.898392 Text en Copyright © 2022 Dällenbach. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Dällenbach, Patrick Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? |
title | Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? |
title_full | Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? |
title_fullStr | Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? |
title_full_unstemmed | Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? |
title_short | Laparoscopic Lateral Suspension (LLS) for the Treatment of Apical Prolapse: A New Gold Standard? |
title_sort | laparoscopic lateral suspension (lls) for the treatment of apical prolapse: a new gold standard? |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406280/ https://www.ncbi.nlm.nih.gov/pubmed/36034345 http://dx.doi.org/10.3389/fsurg.2022.898392 |
work_keys_str_mv | AT dallenbachpatrick laparoscopiclateralsuspensionllsforthetreatmentofapicalprolapseanewgoldstandard |