Innovative vaginal manipulator technique vs. traditional method for vaginal fornix deployment in robotic sacrocolpopexy.

IF 1.6 4区医学 Q2 SURGERY Frontiers in Surgery Pub Date : 2024-11-07 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1491233

Yoshiaki Ota, Kuniaki Ota, Toshifumi Takahashi, Shogo Kawamura, Mitsuru Shiota, Koichiro Shimoya

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Abstract

Introduction and hypothesis: Pelvic organ prolapse (POP) affects approximately 30% of middle-aged and older women, with 11%-19% requiring surgical intervention. Laparoscopic sacrocolpopexy preserves the vaginal axis and length but involves a steep learning curve and longer operation times. Robotic sacrocolpopexy (RSC) addresses these issues, offering enhanced surgical precision. This study aimed to evaluate the feasibility and effectiveness of a novel vaginal manipulator (Hoyte Sacro Tip®; Cooper Surgical, Trumbull, CT, USA) compared with the traditional spatula in RSC.

Methods: This retrospective cohort study included 88 females undergoing RSC at Kawasaki Medical School Hospital between January 2021 and December 2023. Patients were divided into two groups: spatula (n = 50) and vaginal manipulator (n = 38). Data on patient demographics, operative outcomes, and postoperative POP quantification (POP-Q) scores were collected.

Results: Baseline characteristics were similar between the groups, except for gravidity and hypertension, which were higher in the spatula group than that in the vaginal manipulator group. No significant differences were found in operative time, console time, estimated blood loss, or complication rates between the groups (p = 0.08, 0.12, 0.19, and NA, respectively). Hospital stays were shorter in the vaginal manipulator group (median 6.5 vs. 7.0 days, p = 0.03) than in the spatula group. Both groups showed improved POP-Q scores postoperatively. However, the vaginal manipulator group had significantly lower ΔC scores than that of the spatula group (6.26 ± 3.88 vs. 8.53 ± 3.25, p = 0.02).

Conclusions: The vaginal manipulator proved to be a safe and feasible alternative to the traditional spatula, with comparable perioperative outcomes and shorter hospital stays. The manipulator's design facilitated better tissue dissection, potentially improving surgical efficiency.

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机器人骶骨结节成形术中阴道穹窿部署的创新型阴道操纵器技术与传统方法对比。

导言和假设：约 30% 的中老年妇女患有盆腔器官脱垂（POP），其中 11%-19% 需要手术治疗。腹腔镜骶骨整形术可保留阴道轴线和长度，但学习曲线陡峭，手术时间较长。机器人骶尾部整形术（RSC）解决了这些问题，提高了手术的精确度。本研究旨在评估新型阴道操作器（Hoyte Sacro Tip®; Cooper Surgical, Trumbull, CT, USA）与传统刮匙在 RSC 中的可行性和有效性：这项回顾性队列研究包括 2021 年 1 月至 2023 年 12 月期间在川崎医学院附属医院接受 RSC 手术的 88 名女性。患者分为两组：刮刀组（50 人）和阴道机械手组（38 人）。收集了患者人口统计学、手术结果和术后 POP 定量（POP-Q）评分的数据：结果：两组患者的基线特征相似，但刮匙组患者的妊娠率和高血压率高于阴道操作器组。两组在手术时间、控制台时间、估计失血量和并发症发生率方面无明显差异（P = 0.08、0.12、0.19 和 NA）。阴道操作器组的住院时间（中位 6.5 天 vs. 7.0 天，p = 0.03）短于刮刀组。两组术后的 POP-Q 评分均有所提高。然而，阴道操作器组的 ΔC 评分明显低于刮匙组（6.26 ± 3.88 vs. 8.53 ± 3.25，p = 0.02）：阴道操作器被证明是传统刮匙的安全可行的替代品，围手术期结果相当，住院时间更短。阴道操作器的设计有助于更好地剥离组织，从而提高手术效率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.