Laparoscopic sacrocolpopexy with deep attachment of anterior and posterior mesh.

Abstract

Sacrocolpopexy is considered a gold standard to cure apical prolapse, and since the US Food and Drug Administration (FDA) warning about complications of vaginal mesh surgery, the technique is increasingly used. Surgeons perform sacrocolpopexy in different variations, some by attaching the mesh to the apical third of the vagina, and others by applying the mesh anteriorly to the level of the bladder neck and posteriorly to the inner part of the perineum. The different techniques are neither standardized nor evaluated by randomized controlled trials. This video aims to provide insight into the technique of deep placement of anterior and posterior mesh. The video shows that deep mesh placement is feasible and can be performed with standardized parameters. The technique is based on 12 years of experience with laparoscopic sacrocolpopexy; 1- and 5-year results, published in this journal, show it is safe and provides good long-term results.