Efficacy of porcine dermal graft for laparoscopic sacral colpopexy
E. James Wright, Li-Ming Su
Johns Hopkins University, Baltimore, MD
Introduction: Laparoscopic sacral colpopexy (LSC) continues to gain favor as a minimally invasive technique for repairing vaginal vault prolapse. The ideal material and technique for anchorage continues to be debated. We examined the efficacy and durability of a porcine dermal graft for LSC and describe the technique.
Methods: 18 patients with stage 3 or 4 uterovaginal or vaginal vault prolapse had LSC using a continuous porcine dermal graft (pelvicolÃâ€~Ñ®) placed anteriorly and posteriorly. Laparoscopic hysterectomy, colporrhaphy and pubovaginal sling were included when indicated.
Results: All patients had restoration of vaginal vault support to stage 0 or 1 following the procedure. At 21 months mean follow-up (range 2-43 months), 16 of 18 (89 %) patients have no recurrence or progression of vault prolapse. Two patients developed anterior compartment prolapse to stage 3 requiring subsequent repair. These patients did not have a colporrhaphy at the time of LSC. There were no postoperative wound infections, graft erosions or port-site complications.
Conclusion: Porcine dermis is a durable and effective material for LSC to treat vaginal vault prolapse. LSC can be combined with other pelvic reconstructive and continence procedures. Graft infection or erosion was not seen in this series.
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