EVALUATION AND COMPARISON EFFICIENCY OF THE TROCAR AND TROCAR FREE METHODOLOGY OF RECONSTRUCTION OF THE FRONT AND APICAL COMPARTMENTS OF THE PELVIC FLOOR USING SYNTHETIC MESH WITH PELVIC PROLAPSE

Pelvic floor reconstruction with vaginal access using synthetic mesh is a common and effective approach to the treatment of pelvic prolapse positive forms. The current stage in the mesh pelvic surgery development is the best-practice implant placement technique emergence - SIMS (single-incision mesh system).

SIMS fundamental differences: mesh system fixing with harpoon elements (anchor) to the most durable connective tissue structures of the pelvis (sacrospinal ligament, obturator membrane); less traumatization due to the absence need to carry out trocars through the pelvic surface tissues.

According to the recent studies (Lukban JC et al., 2012; RD Moore et al., 2012; EJ Stanford et al., 2013), objective efficacy of the Elevate ™ system using during the year with anterior plastic is from 88% to 92%, the apical - from 89% to 96%, back to 93% [1,2,3]. Comparing SIMS with traditional mesh plastic (210 patients, the follow-up period is 1 year): the anatomical efficiency for the anterior part was 98% versus 87% (p = 0.006), for the apical 99% versus 96% (p = 0.317), and for the posterior 100% versus 97% (p = 0.367) [4]. Nevertheless, there are questions about the reliability of harpoon elements fixing and the new operational methodology safety remain.