title: Vaginally assisted laparoscopic sacrocolpopexy for the treatment of complete uterovaginal prolapse.
abstract: OBJECTIVE
  Women with complete uterovaginal prolapse (UVP) present multicompartmental pelvic defects. The vaginally assisted laparoscopic sacrocolpopexy (VALS) has been introduced to address such defects by combining a vaginal and a laparoscopic approach.
  
  
  METHODS
  This is a video demonstration of a VALS procedure performed on a 60-year-old patient with a complete UVP. The presented procedure comprises two steps: an initial vaginal surgery, followed by a laparoscopic approach. The vaginal surgery initially includes a vaginal hysterectomy and full-thickness dissection of the vaginal walls. The meshes are then sutured on the fascias and the free ends are placed in the pelvic cavity. The vaginal vault is closed transvaginally and then suspended laparoscopically on the sacral promontory.
  
  
  CONCLUSIONS
  The VALS procedure is a valid minimally invasive surgical alternative for patients with severe or complete UVP. This combined procedure facilitates the surgical steps and minimizes the need to perform difficult pelvic laparoscopic dissections.
authors.affiliation: First Department of Obstetrics and Gynecology, Urogynecology Unit, National and Kapodistrian University of Athens, "Alexandra" Hospital, 105-107 Vas. Sofias Avenue, Athens, 11521, Greece, tgregos@yahoo.com.
authors.forename: Themos
authors.initials: T
authors.lastname: Grigoriadis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Protopapas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Chatzipapas
authors.forename: Stavros
authors.initials: S
authors.lastname: Athanasiou
mesh_terms: D000071938:Fasciotomy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D012447:Sacrum / Q000601:surgery; D013526:Surgical Mesh; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery