Abstract:Objective: To explore the feasibility and clinical effect of laparoscopic sacrum fixation with swallow-tailed mesh in the treatment of middle and/or combined posterior pelvic cavity defects. Methods: The clinical data of 4 patients with middle and/or combined posterior pelvic cavity defects treated by laparoscopic sacrum fixation with swallow-tailed mesh in Chongqing Health Center for Women and Children in 2019 were analyzed retrospectively. In this study, self-made mesh and self-designed puncture cone were used to complete the operation. Results: Four patients were diagnosed as middle pelvic cavity combined with posterior pelvic defects, including 3 cases of uterine prolapse with vaginal posterior wall expansion, and 1 case of vaginal vault prolapse with enterocele. All patients received swallow-tailed sacrum fixation and successfully suffered from the operation, without auxiliary vaginal repairment and conversion to open abdomen, and no complications of intestinal tube and other organ damage during the operation. The average time of operation was 166 min, and the average amount of bleeding was 68 mL. All the patients were discharged smoothly 5-6 days after operation. According to the follow-up, ultrasound showed that the pelvic organs were in normal position, the mesh coverage was flat, the rectal and vaginal examination mesh was flat without tension, and the posterior wall of the vagina was soft without swelling. Conclusion: The swallow-tailed sacrum fixation can repair and strengthen the levelⅠdefects as well as the levelⅡandⅢdefects, which is an effective method for the treatment of the middle pelvic cavity defects and the combination of the middle and the posterior pelvic cavity defects, and is also suitable for the diagnosis and treatment of the posterior pelvic cavity defects.
