V272: Laprascopic Four Port Sacralcolpopexy

Video

Introduction and Objectives
The goal of this video is to present a streamlined approach to laparoscopic abdominal sacralcolpopexy. In light of the FDA warnings regarding transvaginal mesh placement and the withdrawal of transvaginal mesh kits from the marketplace, patients are seeking alternative minimally invasive options to address vaginal prolapse. The open abdominal sacralcolpopexy technique has stood the test of time and consistently delivers 95% success rates with tolerable complication rates and specifically, very low mesh complication rates. Translating the open approach to the laparoscopic approach has been made possible with modern technology.

Methods
A compendium of cases by one surgeon is presented in video format to illustrate the main technical points of the procedure. These include: port placement, dissection planes, mesh attachment to vaginal vault and to sacral promontory, and mesh coverage. A novel new vaginal manipulator specifically designed for this procedure will also be shown.

Results
Use of a novel new vaginal manipulator facilitates dissection of the vaginal vault and makes it easier to perform intracorporal laprascopic suturing without the need for expensive robotic technology.

Conclusions
Laparoscopic abdominal sacral colpopexy is feasible and safe and can be performed within a reasonable time frame with few complications, by surgeons who are comfortable with other laparoscopic procedures.

Funding: none