Prospective Evaluation of Laparoscopic Sacrocolpopexy with Concomitant Laparoscopic-Assisted Total Vaginal Hysterectomy

Round 1

Reviewer 1 Report

comments are in  word file

Comments for author File: Comments.pdf

Author Response

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Reviewer 2 Report

Manuscript ID: surgeries-1475279

Journal: Surgeries

Authors:  Ivo Faehnle-Schiegg, Janine Abgottspon, Janine Frey, Joerg Krebs, Corina Christmann-Schmid

 

The manuscript by Ivo Faehnle-Schiegg, Janine Abgottspon, Janine Frey, Joerg Krebs and Corina Christmann-Schmid „Prospective evaluation of laparoscopic sacrocolpopexy with concomitant laparoscopic assisted total vaginal hysterectomy” describe a prospective cohort study of women with an uterovaginal prolapse undergoing laparoscopic SCP with laparoscopic assisted vaginal total hysterectomy (LAVH).

The researches carried out are very interesting. The results are good described, but I suggest extending the information about the patients involved in the experiment. For example, what age range were the patients? Were they in the perimenopause? e.t.c.

I also suggest that you familiarize yourself with the rules for quoting literature. The same journal title is cited differently:

Rondini, C.; Braun, H.; Alvarez, J.; Urzúa, M.J.; Villegas, R.; Wenzel, C.; Descouvieres, C. High Uterosacral Vault Suspension vs Sacrocolpopexy for Treating Apical Defects: A Randomized Controlled Trial with Twelve Months Follow-Up. Int Urogynecol J 2015, 26, 1131–1138, doi:10.1007/s00192-015-2666-0.

Khan, A.; Alperin, M.; Wu, N.; Clemens, J.Q.; Dubina, E.; Pashos, C.L.; Anger, J.T. Comparative Outcomes of Open versus Laparoscopic Sacrocolpopexy among Medicare Beneficiaries. International Urogynecology Journal 2013, 24, 1883–1891, doi:10.1007/s00192-013-2088-9.

Comments for author File: Comments.pdf

Author Response

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Reviewer 3 Report

Reviewer

 

 

Comments and Suggestions for Authors

 

The study collates relevant research well, but does not meet the full requirements of a well-organized discussions section.

I certainly sustain the benefit of TH vs SH, but this paper should answer to a single, clear, focused research question – how this procedure is effective and safe on long-term follow-up. It is nice to have the relevant studies collated and discussed all in one place. 

The manuscript requires major revisions if it is to meet the criteria of an original paper.

 

1. Epidemiological data on the number of patients using the reconstructive procedure

 

2. Lines 59-60 „Vaginal cuff dehiscence is estimated at a rate of 0.39%, and it is more common after total laparoscopic hysterectomy (1.35%) compared with laparoscopic-assisted vaginal hysterectomy (0.28%), total abdominal hysterectomy (0.15%), and total vaginal hysterectomy (0.08%).” 1097/AOG.0b013e3182841594

 

3. Line 64 to comment

 

4. Line 86 to specify the abbreviations

 

5. The degree of uterine prolapse is not mentioned, and the compartment defects.

 

6. To make a table related to the answer to the questionnaires

 

1. Discussion provides minimal analysis (Biological versus syntetic graft in repair procedures for uterine prolapse, comparison with other tehniques, laparoscopic supracervical hysterectomy performed with excision of the endocervix,..)

• Monopolar coagulation and cut modes during colpotomy at total laparoscopic hysterectomy have similar vaginal cuff dehiscence rates and both energy modes seem acceptable for colpotomy. 1016/j.ejogrb.2018.12.034
• Association of the risk factors (lung disease, constipation, collagen disease)

8. There is a lack of references in the last years (2018-2021)

 

9. It will be interesting to show some intraoperative images focused on the technique.

 

1. Future perspectives section is not mentioned, does not put together an analysis, describe next steps, what further knowledge do we need etc.

 

1. Lines 172-174 - Currently, in young women for the treatment of uterine prolapse, laparoscopic sacrohysteropexy with or without mesh is an alternative surgical method to hysterectomy with colpopexy. Therefore, laparoscopic mesh sacrohysteropexy in young patients who want to preserve their uterus and fertility is a low-cost, high-efficiency treatment method.

 

1. Line 190 – please mentioned the protrusion rate.

 

1. Line 195 in conclusions – in elderly women

 

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Dear Editor,

 

The authors followed most of the suggestions and I consider that this article meets the requirements for publication in your journal. However, the lack of images suggestive of the technique used is a shortcoming of this article.

Comments for author File: Comments.pdf