(Video Poster 23) Laparoscopic Sacrohysteropexy

Objectives: To demonstrate and review the surgical steps of laparoscopic sacrohysteropexy, highlighting the relevant anatomy and surgical technique.

Methods: This video presents a step-by-step overview of the surgery, including trocar placement, and dissection of the presacral, rectovaginal and vesicovaginal spaces. The video highlights the anatomical landmarks, optimal mesh configuration, and secure attachment techniques. Special attention is given to safety considerations, with tips to avoid common pitfalls.

Clinical Relevance: Patient-centred care involves considering patients’ values and preferences and engaging them in healthcare decision-making. The literature has shown that most women prefer to preserve the uterus when undergoing prolapse surgery. There is also evidence that hysteropexy is an effective procedure that decreases OR time and blood loss compared to hysterectomy and apical suspension. Furthermore, it is associated with a decreased risk of post-surgical complications, particularly mesh-related complications. Given that laparoscopic sacrohysteropexy is an effective and safe treatment option for prolapse, Urogynecologists should know the technique to offer it to patients.