Pelvic organ prolapse is a common gynecological condition affecting women, particularly those who have had multiple vaginal deliveries, experienced menopause, or undergone pelvic surgeries. Among its variants, uterine prolapse significantly impacts quality of life by causing discomfort, urinary and bowel dysfunction, and sexual problems. Traditionally, hysterectomy was often performed to correct uterine prolapse. However, with advancements in minimally invasive surgery, laparoscopic sacrohysteropexy has emerged as a uterus-preserving, effective, and safe treatment. At the World Laparoscopy Hospital, this procedure is performed with precision, offering women both anatomical correction and improved quality of life.

Introduction

Laparoscopic sacrohysteropexy is a procedure designed to correct uterine prolapse by suspending the uterus to the sacral promontory using a synthetic mesh. Unlike vaginal approaches or hysterectomy, this technique preserves the uterus, maintains reproductive and sexual function, and provides excellent long-term results. The World Laparoscopy Hospital, under the guidance of pioneers like Dr. R. K. Mishra, has refined this procedure, combining advanced laparoscopic skills with evidence-based protocols to achieve optimal outcomes.

Indications for Laparoscopic Sacrohysteropexy

This uterus-preserving procedure is particularly indicated in:

Symptomatic uterine prolapse (grades II–IV) causing discomfort, pelvic pressure, or bulging sensation.

Women seeking uterus preservation for personal, psychological, or reproductive reasons.

Patients with associated apical prolapse, sometimes accompanied by cystocele or rectocele.

Women who have failed conservative management, such as pelvic floor exercises or pessaries.

Contraindications may include active pelvic infection, severe pelvic adhesions, malignancy, or inability to tolerate general anesthesia.

Preoperative Evaluation

Comprehensive evaluation is critical for success. Patients undergo:

Clinical examination using standardized grading systems like the POP-Q (Pelvic Organ Prolapse Quantification).

Ultrasound or MRI for pelvic anatomy assessment.

Urodynamic studies if urinary symptoms are present.

Routine blood tests and anesthesia assessment.

Patients are counseled extensively regarding the procedure, expected outcomes, and potential complications. Informed consent is obtained with emphasis on mesh use and uterus preservation.

Surgical Technique

The procedure at World Laparoscopy Hospital follows a systematic approach to ensure safety and durability:

Anesthesia and Positioning

General anesthesia is administered.

The patient is placed in a lithotomy position with a Trendelenburg tilt to facilitate exposure of the pelvic organs.

Port Placement

A 10 mm camera port is typically placed at the umbilicus.

Two to three working ports (5–10 mm) are inserted in the lower abdomen for laparoscopic instruments.

Exposure and Dissection

The peritoneum over the sacral promontory is carefully dissected to expose the anterior longitudinal ligament.

The uterosacral ligaments and peritoneum over the anterior and posterior aspects of the uterus are mobilized.

Care is taken to avoid injury to major vessels, ureters, and nerves.

Mesh Placement

A synthetic mesh is fixed to the posterior aspect of the uterus or cervix.

The other end of the mesh is anchored securely to the sacral promontory.

The peritoneum is closed over the mesh to prevent adhesions and bowel contact.

Adjunct Procedures

Associated cystocele or rectocele may be repaired concurrently.

Dr. Mishra emphasizes tailored procedures based on patient anatomy and severity of prolapse.

Completion

Hemostasis is confirmed, instruments removed, and port sites closed.

Minimal blood loss and rapid recovery are hallmarks of this minimally invasive approach.

Advantages of Laparoscopic Sacrohysteropexy

At World Laparoscopy Hospital, the procedure offers several benefits over traditional vaginal hysterectomy or open prolapse repair:

Uterus preservation, maintaining reproductive and sexual function.

Excellent anatomical correction, with low recurrence rates.

Minimally invasive: smaller incisions, less pain, and faster recovery.

Reduced hospital stay, often 24–48 hours.

Ability to repair associated defects (bladder or rectal prolapse) simultaneously.

Improved quality of life, with resolution of pelvic pressure, urinary symptoms, and sexual dysfunction.

Postoperative Care

Early ambulation is encouraged to prevent thromboembolic events.

Pain is managed with oral analgesics.

Diet is resumed as tolerated, and patients are usually discharged within 1–2 days.

Follow-up visits include clinical examination and imaging if required.

Patients are advised to avoid heavy lifting or strenuous activity for 6–8 weeks.

Outcomes

Studies and experience at the World Laparoscopy Hospital show:

High patient satisfaction with symptomatic relief.

Low recurrence rates when mesh is adequately anchored.

Minimal complications such as mesh erosion or infection.

Preservation of sexual and reproductive function in most cases.

Conclusion

Laparoscopic sacrohysteropexy at the World Laparoscopy Hospital represents a safe, effective, and minimally invasive solution for uterine prolapse. By combining advanced laparoscopic skills, precise anatomical knowledge, and patient-centered care, this procedure restores normal pelvic anatomy, preserves the uterus, and enhances quality of life. It exemplifies the institution’s commitment to excellence in gynecological surgery and minimally invasive care, providing women with durable, cosmetically favorable, and functionally effective solutions for pelvic organ prolapse.