E-Posters-A Survey of Techniques Used by Female Pelvic Medicine and Reconstructive Surgeons Performing Minimally Invasive Sacral Colpopexy

A Survey of Techniques Used by Female Pelvic Medicine and Reconstructive Surgeons Performing Minimally Invasive Sacral Colpopexy - Alexandra Dubinskaya, MD

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This study aimed to assess the variability of surgical techniques for minimally invasive sacral colpopexy among Female Pelvic Medicine and Reconstructive Surgeons (FPMRS). At the 2018 AUGS annual meeting, 59 out of 671 attendees completed a voluntary and anonymous questionnaire. The respondents were mainly from university-based settings (66.1%) and mostly male (64.4%). The mean age was 47.4 ± 8.6 years, and 47.5% had more than 15 years of experience in practice. <br /><br />Regarding surgical technique, it was found that 50% of surgeons used 3 ports, while the other 50% used 4 ports. In terms of laparoscope use, 46% used a 0-degree scope, and 54% used a combination of 0 and 30 degree scopes. For sacral mesh attachment, 83.1% used sutures, with 56.3% using Gortex, 18.8% using Prolene, and 16.7% using Ethibond. Both anterior and posterior vaginal attachments were made using 5-6 sutures (48.1% and 50%) or 7-8 sutures (35.3% and 31.5%). <br /><br />Some additional findings include the use of PyridiumÒ/uribelÒ and Fluorescein for ureteral efflux identification and the checking of post-operative residual volume by 89.8% of surgeons. Anterior repair was "not usually" or "not at all" performed by 83.4% of surgeons, while posterior repair was performed "often" or "sometimes" by 70.4%. Midurethral sling procedures were performed "often" by 42.6% and "sometimes" by 51.9% of surgeons. Hysteropexy was performed more commonly by female surgeons.<br /><br />The study found that the majority of surgeons performed minimally invasive sacral colpopexy using similar distribution between robotic and laparoscopic approaches. Concomitant surgeries of the posterior wall were more commonly performed than anterior wall surgeries. Female surgeons performed hysteropexy more frequently than male surgeons. No other significant differences in technique were identified based on age, gender, experience, practice setting, or region. However, the low response rate to the survey suggests caution when interpreting the results.

Keywords

surgical techniques

minimally invasive sacral colpopexy

Female Pelvic Medicine and Reconstructive Surgeons

laparoscope use

sacral mesh attachment

vaginal attachments

ureteral efflux identification

post-operative residual volume

hysteropexy

response rate