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Laparoscopic sacropexy and obstructed defecation syndrome: an anatomoclinical study |
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| Authors: | Stefano Cosma Guido Menato Marcello Ceccaroni Gian Luigi Marchino Paolo Petruzzelli Eugenio Volpi Chiara Benedetto |
| Affiliation: | 1. Department of Gynecology and Obstetrics, Sant’Anna Hospital, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy 2. S.C.D.U. Gynecology and Obstetrics, A.O. Ordine Mauriziano, Turin, Italy 3. Department of Gynecology and Obstetrics, Gynecologic Oncology Division, International School of Surgical Anatomy, European Gynecology Endoscopy School, Sacro Cuore General Hospital, Negrar, Verona, Italy 4. Department of Obstetrics and Gynecology, Saint Andrew Hospital, La Spezia, Italy |
| Abstract: | Introduction and hypothesisLaparoscopic sacropexy (LSP) is associated with obstructed defecation syndrome (ODS) in 10–50 % of cases. An anatomoclinical study was carried out to investigate whether there is any correlation between iatrogenic denervation during LSP and ODS.MethodsFive female cadavers were dissected to identify possible sites of nerve injury during LSP. Subsequently, the videos of 18 LSP were blindly reviewed to assess the location of sacral dissection and tacks, the position and depth of the peritoneal tunnel, and another 4 variables. An anatomical triangle was defined on the right lumbosacral spine so as to clearly describe the sites of the surgical variables, which were then statistically correlated with the patients’ postoperative outcome.ResultsThe only variable associated with postsurgical ODS was dissection in the 90° angle of the anatomical triangle, where the superior hypogastric plexus was observed in all cadavers.ConclusionsMedial and midline dissection over the sacral promontory might be associated with postoperative ODS. |
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