자궁 탈출증 환자에서 질식 자궁 절제술과 질식 보조 복강경하 천골 가시인대 고정술

Abstract

The study was to evaluate the effectiveness of a transvaginal assisted laparoscopic sacrocolpopexy which was convenient for suture via vaginal and laparoscopic approach. This study was a prospective analysis of 16 patients who underwent total vaginal hysterectomy with transvaginal assisted laparoscopic sacrocolpopexy with polypropylene mesh (GynecareTM,J&J Inc.) for total uterine prolapse from December 2006 to Feb 2008 in Chosun University Hospital. Total vaginal hysterectomy was performed by traditional method. The Mesh was attached to the anterior and posterior vaginal wall via transvaginal approach. The mesh was attached to the anterior longitudinal ligament via laparoscopic approach. Pelvic organ prolapse was diagnosed using the Pelvic Organ Prolapse Quantification staging system(POPQ). After operation we followed up patients in 30th June 2008. Surgical outcomes were determined by P-QOL and pelvic examination. Wilcoxon Signed Ranks Test was used in statistical analysis. Mean age was 60years(47-78). Mean follow-up period was 15.5 months(range7-24mo). Preexisting urinary incontinence was improved in 3 cases after operation. P-QOL score was improved. Postoperative POP-Q stage was I in all cases. Even though short follow up period(15.5 months), we conclude that total vaginal hysterectomy with transvaginal assisted laparoscopic sacrocolpopexy is easy, feasible, reproducible, and effective surgical method with good anatomic results of the vagina of the patients with total uterine prolapse. Key word : laparoscopic sacrocolpopexy, uterine prolapse