Comparative anatomy of the ovine and human pelvis for laparoscopic sacrocolpopexy: evaluating the effectiveness of the ovine model

Int Urogynecol J. 2023 Sep;34(9):2301-2306. doi: 10.1007/s00192-023-05549-7. Epub 2023 May 8.

Abstract

Introduction and hypothesis: Laparoscopic sacrocolpopexy (LSC) is a functional reconstructive surgery used to treat pelvic organ prolapse (POP) in middle-aged women. Although LSC is widely used, its implementation is hindered by perceived technical difficulties and surgical learning curves. Surgeons require adequate experience with LSC prior to performing the procedure on patients to improve their quality of life. This study is aimed at demonstrating the effectiveness of the ovine model (OM) for training and research in LSC, while also comparing anatomical differences between ovine and human models during the procedure.

Methods: The animal model and training were provided by the Jesús Usón Minimally Invasive Surgery Centre. Urologists and gynecologists with experience in LSC participated in a course and their findings were recorded and documented.

Results: Differences in patient positioning, trocar placement, and reperitonealization were identified between the ovine and human models. Hysterectomy is always performed in the ovine model, whereas it is not mandatory in humans. There are also differences in the dissection of the levator ani muscle and attachment point of the posterior mesh to the uterus between the two models. Despite differences in some areas, the ovine pelvic structure and vagina are similar in size to those of humans.

Conclusions: The ovine model is a valuable tool for surgeons in their learning curve for LSC, allowing for safe and effective practice prior to performing the procedure on patients. The use of the OM can help to improve the quality of life for women affected by pelvic organ prolapse.

Keywords: Female pelvic organ prolapse; Introduction and hypothesis; Laparoscopic sacrocolpopexy; Prolapse surgery; Quality of life.

MeSH terms

  • Anatomy, Comparative
  • Animals
  • Female
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Laparoscopy* / methods
  • Middle Aged
  • Pelvic Floor
  • Pelvic Organ Prolapse* / etiology
  • Pelvic Organ Prolapse* / surgery
  • Quality of Life
  • Sheep
  • Surgical Mesh
  • Treatment Outcome
  • Vagina / surgery