Laparoscopy in urogynaecology

Abstract

Key content Laparoscopic surgery has the potential to further develop urogynaecological surgery. Laparoscopic urogynaecological surgery allows improved visualisation of pelvic organs, reduced postoperative pain, shorter admission and a quicker return to activities of daily living. There is growing interest in new treatments for prolapse with the advent of operations enabling uterine conservation, and a revival in abdominal vaginal vault procedures and colposuspensions. Operative laparoscopy requires a high degree of technical skill and training. It is difficult for trainees to universally gain good exposure to higher laparoscopic training. Learning objectives To understand the different laparoscopic urogynaecology procedures available to treat prolapse and stress incontinence, thus promoting patient choice for surgery. To appreciate the techniques of laparoscopic hysteropexy and laparoscopic colposuspension. To understand the importance of training in laparoscopic urogynaecology, both hands‐on and simulation‐based. Ethical issues Concern regarding complications of vaginally inserted meshes to treat prolapse has increased interest in laparoscopic techniques to treat prolapse. The question is raised as to whether urogynaecology surgery should only be offered at specialist centres.