8588 Tips and Tricks to Perform Laparoscopic Nerve-Preserving Sacrocolpopexy

Abstract

<h3>Study Objective</h3> The objective of this video is to show a nerve- preserving surgical approach for apical prolapse in order to diminish the rate of complications of laparoscopic sacrocolpopexy. <h3>Design</h3> Presentation of one case of a patient with POP-Q stage IV and explain the steps of the surgical approach highlighting the tips and tricks to perform a nerve-preserving sacrocolpopexy <h3>Setting</h3> This procedure was performed at Hospital Militar de Especialidades de la Mujer y Neonatología, Mexico in October 2021. <h3>Patients or Participants</h3> A 68-year-old patient is presented with a history 3 vaginal deliveries and obesity grade I. The patient has previously undergone abdominal hysterectomy in 1990 and came into the consultation with foreign body sensation in the vagina of 1 year of evolution. In the physical examination we diagnose a pop-q stage 4. <h3>Interventions</h3> In this video, show a laparoscopic nerve-preserving sacrocolpopexy for treatment of the apical prolapse. <h3>Measurements and Main Results</h3> The surgical treatment was performed successfully with no trans or post-surgical complications, the surgical bleeding was 10 cc, the surgical time was 150 minutes, the patient was discharged 24 hours after the surgical event. At the follow-up at 6 months the patient is without pelvic pain, without voiding dysfunction, or recurrence of the prolapse. <h3>Conclusion</h3> Performing nerve preservation during sacrocolpopexy is a technique that can be performed systematically and safely, since laparoscopy allows identification of the nerve and vascular structures to be preserved in order to reduce the risk of previously described complications derived from denervation during the open procedure.