A new operation technique for uterine prolapse: Vaginally-assisted laparoscopic sacrohysteropexy/Uterin prolaps icin yeni bir operasyon teknigi: Vajinal asiste laparoskopik sakrohisteropeksi

Objective: To describe the new surgical technique and report the safety and feasibility of vaginally-assisted laparoscopic sacrohysteropexy (VALSH). Materials and Methods: Thirty-three women with stage 3 or more uterine prolapse underwent VALSH operation. Patients were followed up for 12 months for mesh-related complications and improvements of symptoms. The operation had three sections; 1st laparoscopic, 2nd vaginal, 3rd laparoscopic. Results: The mean age, gravidity, and parity of the study population were 46.5 years (range, 25-68 years), 4.3 (1-9), and 2.9 (1-6), respectively. The mean duration of operation was 59.5 min (range, 20-120 min). There were significant differences between the pre- and post-operative values of pelvic organ prolapse quantification parameters, which were favorable in the latter evaluation (p0.05). Conclusion: VALSH is a safe and minimally-invasive procedure in uterovaginal prolapse, with favorable anatomic and functional outcomes at 12 months post-operatively. Keywords: Sacrohysteropexy, laparoscopy, vaginally-assisted laparoscopic sacrohysteropexy Amac: Yeni bir cerrahi yontem tanimlamak ve vajinal asiste laparoskopik sakrohisteropeksi (VALSH) operasyonunun guvenilirligi ve yapilabilirligini rapor etmektir. Gerec ve Yontemler: Evre 3 veya daha ileri duzeyde uterin prolapsusu olan 33 hasta VALSH operasyonuna alindi. Hastalar mese bagli komplikasyonlari ve semptomlari degerlendirme amacli 12 ay takip edildi. Operasyonun uc bolumu vardi: 1. laparoskopik, 2. vajinal, 3. laparoskopik. Bulgular: Calisma grubunda ortalama yas, gravidite, ve parite sirasi ile 46,5 yil (25-68 yil), 4,3 (1-9), ve 2,9 (1-6). Ortalama operasyon suresi 59,5 dk (aralik, 20-120 dk). Sonraki degerlendirmede daha iyi olmak uzere, operasyondan onceki ve sonraki pelvik organ prolapsus-sinifamasi degerlerinde anlamli fark izlendi (p0,05). Sonuc: VALSH uterovajinal prolaps tedavisinde guvenli ve minimal invaziv, anatomik ve fonksiyonel sonuclari iyi olan bir prosedurdur. Anahtar Kelimeler: Sakrohisteropeksi, laparoskopi, vajinal asiste laparoskopik sakrohisteropeksi PRECIS: Vaginally-assisted laparoscopic sacrohysteropexy is a safe, minimally-invasive procedure in uterovaginal prolapse. Twelve months postoperatively, this procedure showed favorable anatomic and functional results.