A new laparoscopic technique for uterine prolapse: one-sided uterine fixation through the round ligament.
OBJECTIVE
In this study, we provide a description of laparoscopic uterine suspension technique through round ligament.


METHODS
From 1997 to 2010, 55 patients with uterine prolapse were treated by laparoscopic uterine suspension. It is performed by suturing and tying a 1-0 Ethibond on the left round ligament at its insertion into the uterus. Then curved forceps pass the lateral puncture wound into the extraperitoneal space along the round ligament and penetrates the anterior leaf of the broad ligament into the peritoneal cavity and grasps the free ends of the Ethibond. They are withdrawn extraperitoneally along the round ligament then tightly tied at the fasciae on either side of the lateral puncture wound.


RESULTS
Forty-two out of 55 patients (76.4%) experienced a reduction of prolapse to stage 0, regardless of what stage they started from. Twelve out of 55 (21.8%) experienced a reduction of prolapse varying from one to two stages. One out of 55 (1.8%) experienced no reduction in prolapse.


CONCLUSIONS
This technique reconstructs a new, inelastic round ligament.
Hsieh
Ching-Hung
CH
Department of Obstetrics and Gynecology, Clinic of Fu Jen Catholic University, Taipei, Taiwan. ug.doc@msa.hinet.net
D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D012404:Round Ligament of Uterus / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*