Feasibility of per-operative transperineal ultrasounds in the visualization of the anterior mesh during laparoscopic sacral colpopexy.

Abstract

When treating anterior and apical prolapse, laparoscopic sacral colpopexy is the gold standard. Currently, it is suggested that the anterior mesh must be the lowest possible to better treat the prolapse and lower the risk of recurrence. The objective of our study was to determine the possibility of using intraoperative transperineal ultrasound measurements during laparoscopic sacral colpopexy in order to better localize the mesh positioning. We conducted a prospective double-blinded single-center study where patients included had intraoperative ultrasounds by an independent ultrasonographer, un-informed of the surgeon's clinical observations. The postoperative measures were performed by another independent ultrasonographer, which was un-informed of the intraoperative measurements. A total of 16 patients were included. The anterior prosthesis was visualized in 81% of patients during laparoscopic sacral colpopexy and in all patients postoperatively. However, intraoperative measures and comparison between intraoperative and postoperative measures significantly varied. None of the patients included had a recurrence of prolapse. LEVEL OF EVIDENCE: 4.