腹腔镜下三种悬吊术治疗盆底脱垂的应用进展
Advances in the Application of Three Laparoscopic Suspension Techniques for Pelvic Organ Prolapse
摘要: 盆腔器官脱垂(Pelvic Organ Prolapse, POP)作为一种常见的盆底功能障碍性疾病,严重影响患者生活质量。随着腹腔镜技术的快速发展,其在POP治疗中的应用日益广泛,特别是在骶前悬吊术(Laparoscopic Sacrocolpopexy, LSCP)、侧腹壁悬吊术(Laparoscopic Lateral Suspension, LLS)和髂耻韧带悬吊术(Laparoscopic Pectopexy, LP)三种主要手术方式中展现出显著的微创优势和良好的临床效果。当前研究聚焦于不同腹腔镜悬吊术的手术技术细节、适应症及其疗效和安全性评估,但仍存在术式选择标准不统一、术后并发症防治策略不足等问题。本文综述了上述三种腹腔镜悬吊术的最新研究进展,比较其技术细节、优缺点及适用人群,旨在为临床医生提供科学、合理的手术方案选择依据。
Abstract: Pelvic Organ Prolapse (POP), a common pelvic floor dysfunction disorder, significantly impacts patients’ quality of life. With the rapid advancement of laparoscopic technology, its application in POP treatment has become increasingly widespread, particularly in three primary surgical approaches: Laparoscopic Sacrocolpopexy (LSCP), Laparoscopic Lateral Suspension (LLS), and Laparoscopic Pectopexy (LP). Current research focuses on the technical details, indications, efficacy, and safety assessment of different laparoscopic suspension procedures. However, challenges persist, including inconsistent criteria for procedure selection and insufficient strategies for preventing and managing postoperative complications. This review summarizes the latest research advances in the three aforementioned laparoscopic suspension techniques, comparing their technical details, advantages, disadvantages, and suitable patient populations. It aims to provide clinicians with a scientific and rational basis for selecting surgical options.
文章引用:郑斌峰, 李元智, 汤武, 杨涛, 方克伟. 腹腔镜下三种悬吊术治疗盆底脱垂的应用进展[J]. 临床医学进展, 2026, 16(2): 2073-2082. https://doi.org/10.12677/acm.2026.162605

参考文献

[1] Jha, P., Sarawagi, R., Malik, R., Kumar, A. and Pushpalatha, K. (2023) Static and Dynamic Magnetic Resonance Imaging in Female Pelvic Floor Dysfunction: Correlation with Pelvic Organ Prolapse Quantification. Cureus, 15, e44915. [Google Scholar] [CrossRef] [PubMed]
[2] Li, Z., Jiang, L., Xu, F., Chen, Q., Wang, F. and Lin, L. (2024) Correlation between Pelvic Floor Four-Dimensional Ultrasound Parameters and POP-Q Score. Technology and Health Care, 33, 1331-1342. [Google Scholar] [CrossRef] [PubMed]
[3] De Vicari, D., Barba, M., Cola, A., Costa, C., Palucci, M. and Frigerio, M. (2025) AI-Enhanced 3D Transperineal Ultrasound: Advancing Biometric Measurements for Precise Prolapse Severity Assessment. Bioengineering, 12, Article 754. [Google Scholar] [CrossRef] [PubMed]
[4] Chen, J. and Luo, J. (2025) Rehabilitation Therapies in Pelvic Floor Dysfunction for Women. Journal of Community Health Nursing, 43, 71-80. [Google Scholar] [CrossRef] [PubMed]
[5] Knol‐de Vries, G.E., Malmberg, G.G.A., Notenboom‐Nas, F.J.M., Voortman, D.B.H., de Groot, A., Dekker, J.H., et al. (2022) Exploring Concomitant Pelvic Floor Symptoms in Community‐Dwelling Females and Males. Neurourology and Urodynamics, 41, 1770-1780. [Google Scholar] [CrossRef] [PubMed]
[6] Martínez‐Galiano, J.M., Peinado‐Molina, R.A., Martínez‐Vazquez, S., Hita‐Contreras, F., Delgado‐Rodríguez, M. and Hernández‐Martínez, A. (2023) Influence of Pelvic Floor Disorders on Sexuality in Women. International Journal of Gynecology & Obstetrics, 164, 1141-1150. [Google Scholar] [CrossRef] [PubMed]
[7] Himmler, M., Kohl, M., Rakhimbayeva, A., Witczak, M., Yassouridis, A. and Liedl, B. (2021) Symptoms of Voiding Dysfunction and Other Coexisting Pelvic Floor Dysfunctions: The Impact of Transvaginal, Mesh-Augmented Sacrospinous Ligament Fixation. International Urogynecology Journal, 32, 2777-2786. [Google Scholar] [CrossRef] [PubMed]
[8] Ayan, A., Cetin, S.Y., Sahin, E.İ. and Buyuk, A. (2023) Investigation of the Relationship between Sexual and Pelvic Floor Dysfunction in Female Patients with Fibromyalgia Syndrome. Women & Health, 63, 615-622. [Google Scholar] [CrossRef] [PubMed]
[9] Tvarožek, S., Szypulová, M., Šteflová, A., Huser, M. and Rušavý, Z. (2025) Sexual Function in Women with Pelvic Organ Prolapse. Česká gynekologie, 90, 64-70. [Google Scholar] [CrossRef] [PubMed]
[10] Sawai, M., Yuno, C., Shogenji, M., Nakada, H., Takeishi, Y., Kawajiri, M., et al. (2022) Prevalence of Symptoms of Pelvic Floor Dysfunction and Related Factors among Japanese Female Healthcare Workers. LUTS: Lower Urinary Tract Symptoms, 14, 380-386. [Google Scholar] [CrossRef] [PubMed]
[11] Panico, G., Campagna, G., Vacca, L., Caramazza, D., Iannone, V., Rossitto, C., et al. (2021) Minimally Invasive Surgery in Urogynecology: A Comparison of Standard Laparoscopic, Minilaparoscopic, Percutaneous Surgical System, and Robotic Sacral Colpopexy. Minerva Medica, 112, 483-491. [Google Scholar] [CrossRef] [PubMed]
[12] Capozzi, V., Scarpelli, E., Armano, G., Monfardini, L., Celardo, A., Munno, G., et al. (2022) Update of Robotic Surgery in Benign Gynecological Pathology: Systematic Review. Medicina, 58, Article 552. [Google Scholar] [CrossRef] [PubMed]
[13] Mueller, M.G., Ashmore, S., Collins, S., Lewicky-Gaupp, C. and Kenton, K. (2024) Single-Port Robotic Sacrocolpopexy: Description of an Advanced Minimally Invasive Approach and Review of the Relevant Literature. International Urogynecology Journal, 35, 1757-1762. [Google Scholar] [CrossRef] [PubMed]
[14] Yu, T. and Liu, L. (2024) The Standardized Procedure, Technical Key Points and Latest Progress of Laparoscopic Lateral Suspension Surgery. Archives of Gynecology and Obstetrics, 310, 1745-1748. [Google Scholar] [CrossRef] [PubMed]
[15] Ablove, T., DeRosa, A., Lewis, S., Benson, K., Mendel, F. and Doyle, S. (2023) Pelvic Floor Pressures Differ Based on Location in the Pelvis and Body Position: A Cadaver Mode. Bioengineering, 10, Article 329. [Google Scholar] [CrossRef] [PubMed]
[16] Roa, L., Larouche, M., Hyakutake, M., Brennand, E.A., Malabarey, O., Koenig, N., et al. (2024) COMET (composite Outcomes of Mesh vs Suture Techniques for Prolapse Repair)-Protocol for a Single Blind Randomized Controlled Multicenter Trial Testing Surgical Innovation in Female Pelvic Surgery. PLOS ONE, 19, e0308926. [Google Scholar] [CrossRef] [PubMed]
[17] Glass Clark, S., Dang, R., Bonnet, S., Zyczynski, H.M. and Giugale, L. (2022) Anatomic Variation of Sacral Mesh Attachment during Minimally Invasive Sacrocolpopexy. Urogynecology, 29, 404-409. [Google Scholar] [CrossRef] [PubMed]
[18] Deffieux, X., Perrouin-Verbe, M., Campagne-Loiseau, S., Donon, L., Levesque, A., Rigaud, J., et al. (2024) Diagnosis and Management of Complications Following Pelvic Organ Prolapse Surgery Using a Synthetic Mesh: French National Guidelines for Clinical Practice. European Journal of Obstetrics & Gynecology and Reproductive Biology, 294, 170-179. [Google Scholar] [CrossRef] [PubMed]
[19] Najib, B., Rusavy, Z., Abdallah, W. and Deval, B. (2023) Laparoscopic Sacrocolpopexy in the Management of Recurrent Pelvic Organ Prolapse. Journal of Gynecology Obstetrics and Human Reproduction, 52, Article 102651. [Google Scholar] [CrossRef] [PubMed]
[20] Ruffolo, A.F., Lallemant, M., Delplanque, S. and Cosson, M. (2023) The Transvaginal Mesh: An Overview of Indications and Contraindications for Its Use. Expert Review of Medical Devices, 20, 393-400. [Google Scholar] [CrossRef] [PubMed]
[21] Winget, V.L., Gabra, M.G., Addis, I.B., Hatch, K.K. and Heusinkveld, J.M. (2022) Laparoscopic Pectopexy for Patients with Intraabdominal Adhesions, Lumbar Spinal Procedures, and Other Contraindications to Sacrocolpopexy: A Case Series. AJOG Global Reports, 2, Article 100034. [Google Scholar] [CrossRef] [PubMed]
[22] Yuqin, L.E.I., Yuchen, S.U.N., Tianyi, S.U.N., Xuesong, H.A.N., Zhiwei, Z.H.A.O. and Yali, M.I.A.O. (2025) Mid-Term Efficacy Evaluation of Laparoscopic Sacrocolpopexy vs Laparoscopic Pectopexy for Pelvic Organ Prolapse. Journal of Sichuan University (Medical Sciences), 56, Article 1104.
[23] Sato, H., Abe, H., Ikeda, A., Miyagawa, T., Sato, K. and Tsukada, S. (2021) Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse in the Elderly: Safety and Outcomes. Journal of Obstetrics and Gynaecology, 42, 110-115. [Google Scholar] [CrossRef] [PubMed]
[24] Campagna, G., Panico, G., Caramazza, D., Anchora, L.P., Parello, A., Gallucci, V., et al. (2020) Laparoscopic Sacrocolpopexy Plus Ventral Rectopexy as Combined Treatment for Multicompartment Pelvic Organ Prolapse. Techniques in Coloproctology, 24, 573-584. [Google Scholar] [CrossRef] [PubMed]
[25] Tagliaferri, V., Taccaliti, C., Romano, F., D’Asta, M., Martulli, B., Gentile, C., et al. (2022) Laparoscopic Sacrocolpopexy versus Pelvic Organ Prolapse Suspension for Surgical Management of Pelvic Organ Prolapse: A Retrospective Study. Journal of Obstetrics and Gynaecology, 42, 2075-2081. [Google Scholar] [CrossRef] [PubMed]
[26] Lange, S., Chatziioannidou, K. and Dällenbach, P. (2023) Robotically Assisted Laparoscopic Lateral Suspension: A Step-By-Step Approach Aiming to Standardize a Novel Procedure. International Urogynecology Journal, 34, 1131-1134. [Google Scholar] [CrossRef] [PubMed]
[27] Akbaba, E. and Sezgin, B. (2021) Modified Laparoscopic Lateral Suspension with a Five-Arm Mesh in Pelvic Organ Prolapse Surgery. BMC Womens Health, 21, Article No. 244. [Google Scholar] [CrossRef] [PubMed]
[28] Pizzoferrato, A., Thuillier, C., Vénara, A., Bornsztein, N., Bouquet, S., Cayrac, M., et al. (2023) Management of Female Pelvic Organ Prolapse—Summary of the 2021 HAS Guidelines. Journal of Gynecology Obstetrics and Human Reproduction, 52, Article 102535. [Google Scholar] [CrossRef] [PubMed]
[29] Wang, Q., Manodoro, S., Jiang, X. and Lin, C. (2025) Efficacy and Safety of Laparoscopic Lateral Suspension with Mesh for Pelvic Organ Prolapse: A Systematic Review and Meta‐Analysis. Acta Obstetricia et Gynecologica Scandinavica, 104, 1603-1615. [Google Scholar] [CrossRef] [PubMed]
[30] Guo, L., Li, X., Li, H., Wang, B., Guo, H. and Wu, J. (2025) Comparative Outcomes of Laparoscopic Lateral Suspension, Sacrocolpopexy, and Transvaginal Mesh for Advanced Apical Prolapse: A Retrospective Cohort Study. PLOS One, 20, e0332526. [Google Scholar] [CrossRef
[31] Simoncini, T., Panattoni, A., Cadenbach-Blome, T., Caiazzo, N., García, M.C., Caretto, M., et al. (2024) Role of Lateral Suspension for the Treatment of Pelvic Organ Prolapse: A Delphi Survey of Expert Panel. Surgical Endoscopy, 38, 4344-4352. [Google Scholar] [CrossRef] [PubMed]
[32] Pitsillidi, A., Grigoriadis, G., Vona, L., Noé, G. and Daniilidis, A. (2025) Patient-Reported Outcomes and Quality of Life after Laparoscopic Pectopexy. Journal of Clinical Medicine, 14, Article 6318. [Google Scholar] [CrossRef
[33] Bolovis, D.I., Schreibmayer, M., Hitzl, W. and Brucker, C.V.M. (2023) Retrospective Analysis of Apical Prolapse Correction by Unilateral Pectineal Suspension: Perioperative and Short-Term Results. International Urogynecology Journal, 34, 1877-1884. [Google Scholar] [CrossRef] [PubMed]
[34] Yu, Y., Mei, L., Chen, Y., Cui, T., Wei, D. and Niu, X. (2025) Comparison of Laparoscopic Lateral Suspension and High Uterosacral Ligament Suspension for Apical Prolapse: A Retrospective Clinical Study. Techniques in Coloproctology, 29, Article No. 84. [Google Scholar] [CrossRef] [PubMed]
[35] Xu, S., Nie, J., Zeng, W., Lai, Y., Chen, X. and Yu, Y. (2023) A Modified Laparoscopic Lateral Suspension with Mesh for Apical and Anterior Pelvic Organ Prolapse: A Retrospective Cohort Study. Videosurgery and Other Miniinvasive Techniques, 18, 690-697. [Google Scholar] [CrossRef] [PubMed]
[36] Baki Erin, K., Taştan, A.Ş., Katırcı, Y., Özdemir, A.Z., Güven, D., Önem, K., et al. (2023) Comparison of 2-Year Follow-Up Outcomes of Laparoscopic Lateral Suspension and Sacrospinous Fixation in Apical Compartment Prolapse: An Observational Study. Archives of Gynecology and Obstetrics, 307, 1859-1865. [Google Scholar] [CrossRef] [PubMed]
[37] Patel, N., Faldu, P., Fayed, M., Milad, H. and Nagaraju, P. (2022) Chronic Pelvic Pain, Quality of Life, and Patient Satisfaction after Robotic Sacrocolpopexy for Pelvic Organ Prolapse. Cureus, 14, e28095. [Google Scholar] [CrossRef] [PubMed]
[38] Carracedo Calvo, D., Pereira Rodriguez, N., Moscatiello, P., Jerez Izquierdo, T., Meilán Hernández, E., Toledo Jimenez, M., et al. (2024) Robotic Sacrocolpopexy for the Treatment of Pelvic Organ Prolapse in Elderly Women: Comparative Analysis of Safety and Efficacy versus Younger Women. Actas Urológicas Españolas (English Edition), 48, 611-617. [Google Scholar] [CrossRef] [PubMed]
[39] Şahin, F., Özdemir, S. and Doğan, O. (2024) Should Sacrouterine Plication Be Added to Lateral Suspension Surgery? A Prospective Study. Journal of Obstetrics and Gynaecology Research, 50, 1042-1050. [Google Scholar] [CrossRef] [PubMed]
[40] Yu, P. and Liu, C. (2023) Laparoscopic Pectopexy with Native Tissue Repair for Pelvic Organ Prolapse. Archives of Gynecology and Obstetrics, 307, 1867-1872. [Google Scholar] [CrossRef] [PubMed]
[41] Geoffrion, R. and Larouche, M. (2021) Guideline No. 413: Surgical Management of Apical Pelvic Organ Prolapse in Women. Journal of Obstetrics and Gynaecology Canada, 43, 511-523.e1. [Google Scholar] [CrossRef] [PubMed]
[42] Orhan, A., Ozerkan, K., Vuruskan, H., Ocakoglu, G., Kasapoglu, I., Koşan, B., et al. (2019) Long-Term Follow-Up of Laparoscopic Sacrocolpopexy: Comparison of Two Different Techniques Used in Urology and Gynecology. International Urogynecology Journal, 30, 623-632. [Google Scholar] [CrossRef] [PubMed]
[43] Baines, G., Price, N., Jefferis, H., Cartwright, R. and Jackson, S.R. (2019) Mesh-Related Complications of Laparoscopic Sacrocolpopexy. International Urogynecology Journal, 30, 1475-1481. [Google Scholar] [CrossRef] [PubMed]
[44] Veit-Rubin, N., Dubuisson, J., Gayet-Ageron, A., Lange, S., Eperon, I. and Dubuisson, J. (2017) Patient Satisfaction after Laparoscopic Lateral Suspension with Mesh for Pelvic Organ Prolapse: Outcome Report of a Continuous Series of 417 Patients. International Urogynecology Journal, 28, 1685-1693. [Google Scholar] [CrossRef] [PubMed]
[45] Hai, P., Tian, Y., Wang, L., Yan, S., Zhang, Y., Wang, Q., et al. (2025) Clinical Application of Laparoscopic Pectopexy in the Treatment of Pelvic Organ Prolapse: Efficacy and Safety. European Journal of Medical Research, 31, Article No. 145. [Google Scholar] [CrossRef
[46] Shenhar, C. and Goldman, H.B. (2024) Management of Sacrocolpopexy Mesh Complications—A Narrative Review and Clinical Experience from a Large-Volume Center. International Urogynecology Journal, 36, 231-241. [Google Scholar] [CrossRef] [PubMed]
[47] Murphy, A.M., Clark, C.B., Denisenko, A.A., D’Amico, M.J. and Vasavada, S.P. (2021) Surgical Management of Vaginal Prolapse: Current Surgical Concepts. The Canadian Journal of Urology, 28, 22-26.
[48] Bolovis, D., Hitzl, W. and Brucker, C. (2021) Robotic Mesh-Supported Pectopexy for Pelvic Organ Prolapse: Expanding the Options of Pelvic Floor Repair. Journal of Robotic Surgery, 16, 815-823. [Google Scholar] [CrossRef] [PubMed]
[49] Tagliaferri, V., Ruggieri, S., Taccaliti, C., Gentile, C., Didonna, T., D’asta, M., et al. (2020) Comparison of Absorbable and Permanent Sutures for Laparoscopic Sacrocervicopexy: A Randomized Controlled Trial. Acta Obstetricia et Gynecologica Scandinavica, 100, 347-352. [Google Scholar] [CrossRef] [PubMed]
[50] Dabica, A., Balint, O., Olaru, F., Secosan, C., Balulescu, L., Brasoveanu, S., et al. (2024) Complications of Pelvic Prolapse Surgery Using Mesh: A Systematic Review. Journal of Personalized Medicine, 14, Article 622. [Google Scholar] [CrossRef] [PubMed]
[51] Paolo, C., Alessandro, A., Salucci, P., Diego, R. and Renato, S. (2020) Laparoscopic Cervicopexy for Correction of Apical Genital Prolapse in 10 Steps: A Pilot Study. International Urogynecology Journal, 32, 1313-1316. [Google Scholar] [CrossRef] [PubMed]
[52] Erdem, B., Salman, S., Usta, Z.K., Bacak, H.B., Özkan, M.D., Çeken, A.T., et al. (2025) A Novel Approach for Apical Prolapse Surgery: Meshless Pectopexy (Salman’s Modification). International Urogynecology Journal, 36, 1701-1705. [Google Scholar] [CrossRef] [PubMed]
[53] Lin, M., Lu, Y. and Chen, J. (2022) Tissue-Engineered Repair Material for Pelvic Floor Dysfunction. Frontiers in Bioengineering and Biotechnology, 10, Article ID: 968482. [Google Scholar] [CrossRef] [PubMed]