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02 March 2023, Volume 39 Issue 3 Previous Issue   

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Development overview of sacrocolpopexy. TONG Xiao-wen 2023, 39(3): 260-263.  DOI: 10.19538/j.fk2023030102 Abstract ( )   Pelvic organs prolapse（POP）is a series of functional abnormalities caused by the dysfunction of the pelvic floor support structures due to various causes.The treatment includes conservative treatment and surgeries.With the coming of going，the morbidity of POP is increasing year by year，which serious affects the wome's life quality and psychology health.Surgeries include traditional surgery and reconstructive surgery，among which sacrocolpopexy is the "gold standard" treatment for apical prolapse because of its good anatomical repositioning and high cure rate.With the development of the times，the procedure of sacrocolpopexy has also changed to some extent.The development，indications，surgical procedures and training of sacrocolpopexy are reviewed to provide a basis for the formulation of relevant clinical decisions.

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Selection of mesh type and suture location in laparoscopic sacropexy. LU Shen-tao, ZHAO Cheng-zhi, LIU Lu-bin 2023, 39(3): 264-267.  DOI: 10.19538/j.fk2023030103 Abstract ( )   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）.

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Advantages and disadvantages of preserving the uterus or cervix in laparoscopic sacral colpopexy. HONG Li, LIU Cheng 2023, 39(3): 268-272.  DOI: 10.19538/j.fk2023030104 Abstract ( )   Pelvic organ prolapse（POP）is characterized by the downward displacement and disorder of pelvic organs caused by generative changes of pelvic floor muscles，fascia and other supporting tissues.POP is common in middle-aged and elderly women，which seriously impacts the patient's quality of life.Reconstructive surgery is the most effective treatment for symptomatic POP with moderate to severe grade.Laparoscopic sacral colopexy is the gold standard for vaginal apical prolapse and other defects of the middle pelvic department.Clinically，there are three subtypes of surgery derived from this procedure：uterus sparing laparoscopic sacrohysteropexy（LSH），cervix-sparing laparoscopic sacrocervicopexy（LSCP），and laparoscopic sacrocolpopexy（LSC）.Generally，either LSH or LSCP is recommended for young，sexually active patients who wish to preserve the uterus/cervix，and are subject to exclusion of contraindications.This article discusses the clinical value of uterus / cervix preservation in laparoscopic sacral colopexy.

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Comparison between laparoscopic sacrocolpopexy and other apical suspension surgery.  XIANG Xue-bing, XIA Zhi-jun 2023, 39(3): 272-276.  DOI: 10.19538/j.fk2023030105 Abstract ( )   With the aggravation of the aging society and the further improvement of people's life quality，the incidence of POP and the rate of consultation have gradually increased.Middle pelvic defect is a defect in the apical support structure of the vagina.It is characterized by uterine or vaginal vault prolapse，enterocele and vault herniation，and is a common type in POP.There are many surgical methods for the treatment of pelvic defects，mainly including sacrocolpopexy（SC）、uterosacral ligament suspension（USLS）、sacrospinous ligament fixation（SSLF），Manchester-Fothergill procedure（MF），and transvaginal mesh surgery（TVM），etc.This paper aims to make a comprehensive analysis and comparison of various surgical methods for middle pelvic defects.

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Mesh-related complications and management after laparoscopic sacrocolpopexy. HUA Ke-qin, WANG Xiao-juan 2023, 39(3): 276-279.  DOI: 10.19538/j.fk2023030106 Abstract ( )   Mesh-related complications after laparoscopic sacrocolpopexy mainly include mesh exposure，erosion，infection and pain，et al.These complications may be due to the patient-related factors，surgical factors and mesh factors，et al，which usually are not unique causes.Anti-infection and mesh excision are the main measures to treat mesh-related complication.

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Establishment and management of Chinese pelvic reconstruction surgery with prothesis registry database. LIANG Shuo 2023, 39(3): 279-282.  DOI: 10.19538/j.fk2023030107 Abstract ( )   The complications related to the prostheses in female pelvic reconstruction surgery（FPRS）have been widely recognized and highlighted as an important indicator of the surgical outcome.This article will present the international development of the FPRS and related complication registries，the establishment of Chinese Female Pelvic Floor Surgery Database as well as the operation mode of this platform.

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Application of enhanced recovery after surgery in perioperative period of laparoscopic sacrocolpopexy.  SONG Xiao-chen 2023, 39(3): 282-285.  DOI: 10.19538/j.fk2023030108 Abstract ( )   Enhanced Recovery After Surgery（ERAS）is a series of perioperative optimal treatment measures based on evidence-based medicine to reduce surgical trauma and stress，reduce postoperative pain，promote early food-taking and postoperative recovery of patients.The successful implementation of ERAS requires multidisciplinary cooperation.This article takes the application of ERAS in perioperative period of laparoscopic sacrocolpopexy as an introduction，and combines the AUGS-IUGA Joint clinical consensus statement on ERAS after urogynecologic surgery and summarizes the problems in clinical practice，in order to provide reference for the clinical application of ERAS.

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Current situation and progress of robotic-assisted sacrocolpopexy. ZHANG Xiao-wei, DENG Tuo 2023, 39(3): 285-288.  DOI: 10.19538/j.fk2023030109 Abstract ( )   Sacrocolpopexy is generally recognized as the gold standard procedure for the treatment of vaginal vault prolapse.Among them，laparoscopic sacrocolpopexy has advantages such as small trauma，high cure rate and low recurrence rate.In recent years，robotic-assisted sacrocolpopexy，as an emerging surgical technique，has attracted much attention and has great clinical application and promotion prospects.

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Recurrent pelvic organ prolapse and strategic management after surgery. LU Yong-xian 2023, 39(3): 289-295.  DOI: 10.19538/j.fk2023030110 Abstract ( )   There is still a high recurrence rate of pevic organ prolaps（POP）after suryery.The patients themselves may have multiple high recurrent risks.Inadiquate surgery，unidentified related all the pelvic defects and not repair them or the procedures choosed not correctly，surgeons training are not enough and can not master the procedures are all high reisk factors，which may result in recurrence of the POP surgery.We have known some definite risk fators，but for some others we haven’t know them well.Forthermore，some recurrence of POP surgery is caused by the combination of multiple factors.Severity，location and bothersome symptom of POP should be assessed before the reoperation.For the treatment strategies of recurrent POP，there are two methods.One is conservative measures，and the other is reoperation.The former can relieve the symptoms and postpone POP progression，and the latter can solve and correct recurrent POP.The repeat operation for recurrent POP is difficult and there is no high lever evidence to support what is the best procedure.The individual procedure based on the characteristics of recurrent POP should be designed.At the present it is recommended that abdominal sacrocolopopexy or transvaginal mesh could be chosen as relatively better precedure for the recurrent POP.The mesh may be needed to reinforce the repairment.Any surgical procedure should be carried out by subspecialtized trained and experienced surgeons with an adequate clinical experience and good results.It is necessary sometimes to need Multidisciplinary consultation and joint management.