Abstract
The objective of this video is to demonstrate techniques for minimally invasive abdominal sacrocolpopexy for recurrent pelvic organ prolapse after prior sacrocolpopexy. Sacrocolpopexy is considered by many to be the gold standard for repair of apical pelvic organ prolapse. Although rates of surgical failure and repeat surgery are low, prolapse recurrence can occur after sacrocolpopexy. In this video, we review recurrence rates of prolapse after minimally invasive abdominal sacrocolpopexy (MI-SCP), discuss two cases of prolapse recurrence following MI-SCP and subsequent surgical repair of recurrence with repeat MI-SCP, and present clinical tips and tricks for repeat MI-SCP. Through both cases, we illustrate three key principles for approaching a repeat MI-SCP: assessment of prior surgical repair and identification of cause of anatomic failure, re-establishment of normal anatomy via lysis of adhesions, and resection of prior mesh and/or attachment of new mesh. The use of robotic assistance for dissection is also demonstrated. Despite the high durability of sacrocolpopexy, prolapse recurrence can still occur over time. Appropriate cases of prolapse recurrence can be managed in a minimally invasive manner with repeat MI-SCP.
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