Laparoscopic high uterosacral ligament suspension: an alternative route for a traditional technique

Introduction and hypothesis Uterovaginal prolapse treatment is a challenge for the urogynecologist. Surgical management for apical prolapse can be successful with native tissue and uterosacral ligament (USL) fixation. However, some complications have been described, especially with use of the vagina...

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Bibliographic Details
Published in:International Urogynecology Journal 2018-08, Vol.29 (8), p.1227-1229
Main Authors: Panico, Giovanni, Campagna, Giuseppe, Caramazza, Daniela, Amato, Nicola, Ercoli, Alfredo, Scambia, Giovanni, Cervigni, Mauro, Zaccoletti, Riccardo
Format: Article
Language:English
Subjects:
Aged
Female
Gynecologic Surgical Procedures - methods
Gynecology
Humans
IUJ Video
Laparoscopy
Ligaments
Medicine
Medicine & Public Health
Pelvic Organ Prolapse - surgery
Surgical techniques
Urology
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Summary:Introduction and hypothesis Uterovaginal prolapse treatment is a challenge for the urogynecologist. Surgical management for apical prolapse can be successful with native tissue and uterosacral ligament (USL) fixation. However, some complications have been described, especially with use of the vaginal approach. The aim of this video is to describe an alternative laparoscopic approach to a traditional vaginal procedure to reduce nerve injury and ureteral complications. Methods A 75-year-old woman was referred to our unit for symptomatic stage III apical prolapse and underwent laparoscopic USL fixation, according to the technique described herein. Results This surgical technique was successful in correcting apical prolapse. Conclusions This video tutorial may be useful to urogynecologists for improving surgical technique, thus leading to a reduction in the risk of nerve and ureteral complications. The technique offers the possibility of a correct under-vision suture positioning. Laparoscopic USL fixation can be safely performed to treat apical prolapse.
ISSN:0937-3462
1433-3023
DOI:10.1007/s00192-018-3588-4