Uterine prolapse, the downward displacement of the uterus due to weakening of the pelvic floor muscles and supportive ligaments, is a common gynecological problem that can significantly affect a woman’s quality of life. Symptoms often include a sensation of pelvic heaviness, vaginal bulging, urinary problems, constipation, and difficulty with sexual intercourse. Traditionally, hysterectomy was considered the definitive treatment for prolapse. However, with advances in minimally invasive gynecology, uterus-preserving procedures such as laparoscopic uterine suspension have become increasingly popular.

At World Laparoscopy Hospital, Dr. R. K. Mishra, an internationally renowned laparoscopic surgeon and trainer, has pioneered safe, effective, and fertility-preserving techniques for laparoscopic uterine suspension. His approach focuses on restoring normal pelvic anatomy, maintaining the uterus when desired, and ensuring long-term relief from prolapse symptoms with minimal invasiveness.

What is Laparoscopic Uterine Suspension?

Laparoscopic uterine suspension is a surgical procedure in which the uterus is elevated and secured in its normal anatomical position using sutures or mesh attached to strong pelvic ligaments or the sacral promontory. Unlike hysterectomy, this procedure allows women to retain their uterus, which is particularly valuable for younger patients wishing to preserve fertility or for those with cultural or psychological reasons for uterine conservation.

The main goals of laparoscopic uterine suspension are:

To correct uterine prolapse and prevent recurrence.

To restore pelvic floor support.

To maintain vaginal length and axis for sexual function.

To preserve fertility whenever desired.

Advantages of the Laparoscopic Approach

Compared to open surgery or vaginal procedures, laparoscopy provides clear advantages:

Minimally invasive – Small incisions, less pain, and faster healing.

Enhanced visualization – Magnified, high-definition view of pelvic structures allows precise dissection and suturing.

Preservation of uterus – Maintains hormonal, psychological, and reproductive benefits.

Cosmetic outcomes – Minimal scarring.

Shorter recovery – Most women return to daily activities within a week.

Surgical Technique by Dr. R. K. Mishra

Dr. Mishra’s demonstration of laparoscopic uterine suspension combines meticulous surgical technique with modern laparoscopic principles. The steps generally include:

Preoperative Evaluation

Detailed pelvic examination and imaging to assess the degree of prolapse.

Counseling the patient regarding options, outcomes, and fertility considerations.

General anesthesia and patient preparation.

Patient Positioning and Port Placement

The patient is placed in lithotomy position with Trendelenburg tilt.

Pneumoperitoneum is created using a Veress needle or open technique.

A 10 mm umbilical port for the laparoscope and additional 5 mm accessory ports are inserted under vision.

Exposure and Dissection

The uterus is elevated to identify pelvic support structures.

Peritoneum over the sacral promontory or uterosacral ligaments is incised to expose strong anchoring points.

Suspension Techniques

Different suspension methods are used depending on the case:

Uterosacral Suspension: Non-absorbable sutures fix the cervix or uterine isthmus to the uterosacral ligaments, providing posterior support.

Round Ligament Suspension: The round ligaments are shortened and anchored to the anterior abdominal wall.

Sacrohysteropexy: A synthetic Y-shaped mesh is used to attach the cervix or uterus to the sacral promontory, ensuring durable apical support.

Final Steps

Proper tension is ensured so that the uterus is restored to its normal position without being over-corrected.

If mesh is used, peritoneum is closed over it to prevent bowel adhesions.

Hemostasis is confirmed, and ports are closed.

Postoperative Care

Recovery after laparoscopic uterine suspension is typically rapid:

Hospital stay: 24–48 hours in most cases.

Pain control: Mild analgesics are sufficient.

Activity: Early ambulation is encouraged; strenuous exercise and heavy lifting are avoided for 6–8 weeks.

Sexual activity: Generally resumed after 8 weeks, once healing is complete.

Follow-up: Regular visits to ensure anatomical correction and absence of recurrence.

Outcomes and Success Rates

Dr. Mishra’s expertise in laparoscopic uterine suspension has consistently shown excellent results:

High rates of anatomical correction.

Significant improvement in pelvic floor symptoms.

Preservation of vaginal length and sexual function.

Fertility preserved in women desiring future pregnancies.

Low recurrence rates compared to vaginal suspension techniques.

Risks and Considerations

Although safe in experienced hands, some risks exist:

Injury to bladder, ureters, or bowel.

Mesh-related complications (erosion or infection), though rare.

Recurrence in severe or advanced prolapse cases.

Technical challenges in patients with previous pelvic surgeries or dense adhesions.

Proper patient selection and advanced laparoscopic training minimize these risks.

Conclusion

Laparoscopic uterine suspension, as demonstrated by Dr. R. K. Mishra at World Laparoscopy Hospital, represents a modern, effective, and uterus-preserving solution for women suffering from uterine prolapse. With its minimally invasive nature, quick recovery, and durable results, this procedure offers hope and confidence to women who wish to maintain their uterus while regaining pelvic health.

Dr. Mishra’s expertise ensures that patients receive world-class care, blending innovation with safety. For young women, women desiring fertility preservation, or those seeking alternatives to hysterectomy, laparoscopic uterine suspension provides the ideal balance of medical science and compassionate care.