Abstract
Study Objective To demonstrate a technique of laparoscopic uterosacral ligament hysteropexy. Design A step-by-step description of the procedure (instructional video). Setting N/A Patients or Participants The patient is a 30 year old with Stage III apical pelvic organ prolapse. She was unsure about desire for future pregnancy and elected for uterine-sparing repair. Interventions The first step of laparoscopic uterosacral ligament hysteropexy involves creating peritoneal relaxing incisions between both uterosacral ligaments and the ureters. This functions to prevent ureter kinking when the uterosacral ligaments are plicated. Next, plication of the uterosacral ligament is performed using 0-Polyester suture. The suture is guided through the proximal portion of the uterosacral ligament, the midportion of the uterosacral ligament, and the insertion of the uterosacral ligament at the cervix. Uterosacral ligament plication restores the normal anatomy of the uterosacral ligaments. At the conclusion of the case, cystoscopy is performed to ensure ureteral patency. Measurements and Main Results N/A Conclusion Laparoscopic uterosacral ligament hysteropexy is a safe and effective treatment for apical pelvic organ prolapse.
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