Laparoscopic lateral suspension for apical vaginal wall prolapse: review article

Abstract

: Laparoscopic lateral suspension with utilizing mesh for pelvic organ prolapse has gained much attention and popularity globally. Laparoscopic lateral suspension, technique has evolved or modified according to the surgical outcomes and innovation of technology throughout the years since first reported. Laparoscopic lateral suspension aimed to treat apical and anterior vaginal wall prolapse. Laparoscopic sacrocolpopexy has admitted to be gold standard technique for the treatment of apical prolapse. However, it substantially depends on surgical skill and expertise due to dissection at the level of the promontory hence this could be challenging, particularly in obese women and when an anatomical variation exists and this might be associated with rare but serious neurological or ureteral morbidity as well as life-threatening vascular injury. Laparoscopic lateral suspension is technically easier to perform and provides shorter time to operate, as well. Considering apical defect is more common in elderly patient population, shorter surgery time will be an offering of the laparoscopic lateral suspension to this group. Laparoscopic lateral suspension is feasible, reproducible, safe, and effective technique. Hence, laparoscopic lateral suspension should not be evaluated as a replacement procedure to sacrocolpopexy. However, in selected cases it would be a feasible alternative in apical and anterior vaginal wall prolapse.