Vaginally assisted laparoscopic sacrocolpopexy for the treatment of complete uterovaginal prolapse.

INTRODUCTION AND HYPOTHESIS: 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.

METHOD: 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.