腹腔镜骶骨固定术网片类型及缝合位置选择

Selection of mesh type and suture location in laparoscopic sacropexy.

腹腔镜骶骨固定术是治疗顶端脱垂(Ⅰ水平缺陷)的“金标准”术式,包括阴道骶骨固定术、子宫骶骨固定术和子宫颈骶骨固定术。手术需要选择使用各种不同的修复材料,目前聚丙烯合成网片仍是使用较多的,阴道骶骨固定术建议采用成型的Y型大孔径聚丙烯编织网片,子宫颈和子宫骶骨固定术可采用Ⅰ型大孔径单股纤维编织的轻型聚丙烯片状网片自行裁剪。在不同缝合位置的选择上,目前大部分学者推荐固定在第1骶椎(S1)的前纵韧带上。

Laparoscopic sacropexy is the"gold standard"procedure for the treatment of apical prolapse(level I defect)and includes:laparoscopic sacrocolpopexy(LSC),laparoscopic sacral hysteropexy(LSH)and laparoscopic subtotal hysterectomy plus cervicopexy(LSHCP).Different repair materials are chosen for the surgery.At present,polypropylene synthetic mesh is still the most mature mesh.The molded Y mesh is recommended for LSC,and the ordinary sheet mesh can be customized for LSH and LSHCP.Most scholars recommend that the suture location is set on the anterior longitudinal ligament of the first sacral vertebra(S1).