Laparoscopic Pectopexy

• Main Author: Palmas, Artur
• Publication Date: 2017
• Other Authors: Domingues, Nuno, Santos, Carlos, Pires, Macieira
• Format: Article
• Language: por
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: https://doi.org/10.24915/aup.34.3-4.25
• topic: Laparoscopy/methods; Ligaments/surgery; Pelvic Organ Prolapse/surgery; Prostheses and Implants; Laparoscopia/métodos; Ligamentos/cirurgia; Prolapso Órgãos Pélvicos/cirurgia; Próteses e Implantes

Different operative approaches for the repair of a genital prolapse have been reported. However, for the reconstitution of a physiological axis of the vagina, a sacropexy seems to be the most adequate approach. We describe a method of laparoscopic apical prolapse surgery, where the lateral parts of the iliopectineal ligament are used for a bilateral mesh fixation of the descended structures. The iliopectineal ligament is a stable structure for the fixation of meshes and sutures, statistically significant stronger than the sacrospinous ligament and arcus tendinous of pelvic fascia. The incidence of defecation disorders, are reduced by a more physiological lateral fixation, which does not reduce the pelvic space. We used a single-port transumbilical device, with an additional 5 mm port, where at the end of the procedure, the drain is placed. This technique, a virtually scarless surgery, represents also, an option for women, who have an esthetic concern about scars.