The use of laparoscopic sacrocolpopexy in the management of pelvic organ prolapse.
OBJECTIVE
This paper aims to review and comment on the developments in laparoscopic sacrocolpopexy published during the last year.


RESULTS
We classified the findings reported recently in the literature for laparoscopic sacrocolpopexy as technical or tactical findings. Technical findings concern the material of the mesh, the methods of mesh fixation, the use of adapted vaginal retractors and the interest in robotic assistance. Tactical findings consist of specific modifications to the standard surgical procedure aimed at reducing the side effects and complications and ameliorating the effectiveness of this intervention. These modifications include the possibility of avoiding the placement of a posterior mesh and the fixation of the posterior mesh to the puborectal muscles or the perineal body instead of the posterior vaginal wall. A specific section has been dedicated to reviewing and commenting on those interventions associated routinely with laparoscopic sacrocolpopexy.


CONCLUSIONS
Laparoscopic sacrocolpopexy is a safe surgical procedure in constant evolution which allows excellent results in the treatment of utero-vaginal prolapse. Large prospective, randomized studies comparing the different technical and tactical modifications recently introduced are needed in order to further enhance the effectiveness of this intervention.
Department of Visceral and Gynaecologic Surgery, Hôpital des Diaconesses, 18, rue du Sergent Bauchat--75571 Paris Cedex 12, France. drgadonneix@aol.com
Pierre
P
Gadonneix
Alfredo
A
Ercoli
Giovanni
G
Scambia
Richard
R
Villet
D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*