7419 Vaginally Assisted Laparoscopic Sacrocolpopexy

Abstract

<h3>Study Objective</h3> The objective of this video is to demonstrate the surgical technique for attaching sacrocolpopexy mesh using a vaginal approach. We will highlight the steps of the procedure and discuss findings in the literature to support this approach. <h3>Design</h3> Surgical video recording of vaginal and laparoscopic procedures to demonstrate the steps of this technique for prolapse repair. <h3>Setting</h3> Operating Room <h3>Patients or Participants</h3> 69-year-old female with stage III anterior and apical pelvic organ prolapse who desired surgical management. <h3>Interventions</h3> Total vaginal hysterectomy, followed by mesh attachment via a vaginal approach for stage III pelvic organ prolapse. Laparoscopic sacrocolpopexy was then performed in the routine fashion. Excellent apical support was noted at completion of the procedure. <h3>Measurements and Main Results</h3> Vaginal mesh attachment after hysterectomy and prior to laparoscopic sacrocolpopexy has shorter mean operating room times with no significant difference in complication rates or anatomic outcomes. Mesh exposure is not significantly higher in those who have vaginal mesh attachment vs. laparoscopic mesh attachment. <h3>Conclusion</h3> Vaginally attached mesh prior to laparoscopic sacrocolpopexy is an efficient way to perform minimally invasive sacrocolpopexy in patients with stage 3 or greater pelvic organ prolapse, and with the appropriately selected patient, allows for same day discharge.