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Watch this detailed video on Laparoscopic Pectopexy, a minimally invasive surgery for pelvic organ prolapse. Dr. R.K. Mishra demonstrates the step-by-step laparoscopic procedure, highlighting techniques, safety tips, and patient outcomes. This video is perfect for surgeons, trainees, and anyone interested in advanced laparoscopic surgery.

Although laparoscopic Sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical uterine prolapse surgery. The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period. 

Pelvic organ prolapse (POP) is a common condition, particularly in women who have experienced childbirth, aging, or hormonal changes. It occurs when the pelvic organs, such as the uterus, bladder, or rectum, descend into or outside the vaginal canal due to weakened pelvic floor support. While traditional surgical options exist, minimally invasive techniques like Laparoscopic Pectopexy are increasingly preferred due to their safety, efficacy, and faster recovery.

What is Laparoscopic Pectopexy?

Laparoscopic Pectopexy is a minimally invasive surgical procedure designed to correct pelvic organ prolapse, particularly uterine or vaginal vault prolapse. Instead of attaching the prolapsed organ to the sacral promontory (as in sacrocolpopexy), the uterus or vaginal vault is fixed to the pectineal (Cooper’s) ligament on both sides using a mesh. This avoids interference with the presacral space, reducing the risk of complications related to blood vessels and nerves.

Indications for Pectopexy

Laparoscopic Pectopexy is recommended for patients with:

Symptomatic uterine prolapse

Vaginal vault prolapse after hysterectomy

Pelvic organ prolapse with comorbidities making traditional sacrocolpopexy risky

Desire for minimally invasive surgical correction

Advantages of Laparoscopic Pectopexy

Minimally Invasive: Small laparoscopic incisions reduce postoperative pain, scarring, and hospital stay.

Reduced Complications: Avoids the presacral space, lowering the risk of bleeding and nerve injury.

Preservation of Pelvic Function: Maintains vaginal axis and sexual function.

Quick Recovery: Most patients return to daily activities within 2–4 weeks.

High Success Rates: Studies show excellent anatomical and functional outcomes.

Surgical Technique

The procedure involves the following steps:

Patient Preparation: Under general anesthesia, the patient is positioned in a lithotomy trendelenburg position.

Trocar Placement: Small laparoscopic ports are inserted in the abdominal wall.

Dissection: The pelvic cavity is carefully dissected to expose the pectineal ligaments.

Mesh Attachment: A surgical mesh is fixed to the prolapsed organ and anchored to both pectineal ligaments.

Closure and Recovery: The mesh is tension-free, ensuring proper support, and incisions are closed.

Postoperative Care

Short hospital stay (usually 24–48 hours)

Pain management with oral analgesics

Avoid heavy lifting or strenuous activity for 4–6 weeks

Follow-up to monitor mesh integration and pelvic function

Conclusion

Laparoscopic Pectopexy is a safe, effective, and modern alternative to traditional prolapse surgeries. By combining the benefits of laparoscopy with the anatomical advantages of pectineal ligament fixation, it provides excellent outcomes with minimal complications. Patients experience faster recovery, improved quality of life, and restored pelvic function, making it a preferred choice for contemporary pelvic reconstructive surgery.