Hypothesis / aims of study
Fascia lata is a versatile graft that has applications in various surgical fields. There is increased interest in the use of autologous fascia lata in pelvic floor reconstruction as an alternative to synthetic mesh given their complications. However, there are also concerns regarding the potential morbidity of harvesting large amount of fascia lata required for pelvic organ prolapse (POP) repair. We report our experience in 71 patients who underwent large fascia lata harvest for POP repair.
Study design, materials and methods
A 4-5-cm x 14-18-cm piece of fascia lata is harvested through a single, minimally invasive 3-4-inch lateral upper thigh incision and used for either autologous transvaginal POP repair or autologous sacrocolpopexy. The landmarks of fascia harvest are 4-5 cm anterior and parallel to the sulcus between the vastus lateralis and the biceps femoris muscles, 15 cm inferior to the anterior superior iliac spine, and 10 cm superior to the lateral femoral condyle. Defect in the fascia lata not closed to prevent compartment syndrome. A Jackson-Pratt drain is placed in the harvest site to prevent seromas, and a compression bandage is applied for four-six weeks post-operatively. An On-Q pain pump is placed in the wound for post-operative pain control. Patients were followed by history, physical exam, and symptoms related to thigh harvest including visual analog pain (VAP) scores, thigh bulges, harvest site seromas/fluid collections, and paresthesia.
Interpretation of results
Facia lata harvest site issues were minor and managed expectantly. Large fascia lata harvests are not morbid for these patients.