Safety, Efficacy, and Cost-effectiveness of Organ Suspension in Laparoscopic Gynecologic Surgery. A Retrospective Cohort Study to Validate an Innovative Technique: Laparoscopic Organ Suspension sec. Angioni

Angioni, Stefano

First

;Saponara, Stefania

;D'Ancona, Gianmarco;Sicilia, Gilda;D'Alterio, Maurizio Nicola;Vitale, Salvatore Giovanni

Last

In press

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Abstract

Objectives: This study aims to evaluate the safety, efficacy, and cost-effectiveness of the Laparoscopic Organ Suspension sec. Angioni, an innovative approach to transient organ suspension (OS) in laparoscopic gynecological procedures. Recognizing the need to enhance surgical site access and overcome limitations of existing organ retraction methods, the study investigates a novel, in-theatre constructed OS device. Design: This retrospective observational study was conducted from March 2019 to May 2021 and included 330 patients who underwent multiport or single-site-port laparoscopic surgery employing Angioni's Technique for transient pelvic organ suspension. Participants/materials, setting, methods: Participants included individuals undergoing surgery for conditions such as endometriosis, ovarian cancer, endometrial cancer, pelvic prolapse, and benign ovarian cysts. The Laparoscopic Organ Suspension sec. Angioni utilizes a segment of a Foley catheter connected to a Polyglactin suture to provide adjustable tension, minimizing the need for reconfiguration during surgery. Results: The application of this OS technique resulted in an average suspension time of 1.9 minutes, with no significant difference between senior and junior surgeons. The method proved more time-efficient for posterior peritoneum suspension than other published methods and showed no additional risks of organ damage, bleeding, conversion to laparotomy, or OS-related complications. The secondary outcomes revealed reduced hospital stays and minimal blood loss, highlighting the procedure's overall efficiency. Limitations: Given its retrospective and single-center nature, the study's results may not be widely generalizable. Prospective multicentric comparative studies are recommended to to further validate the Angioni's Technique. Conclusions: Laparoscopic Organ Suspension sec. Angioni is introduced as a straightforward, safe, and cost-effective method that significantly streamlines the surgical process. Its adaptability and ease of use suggest that it could be a valuable addition to current gynecological surgical practices, with potential implications for increasing efficiency and reducing procedural costs. Future studies are required to confirm these results across diverse clinical environments.