The autologous vaginal patch plastron associated with the anterior sacrospinous ligament fixation for the treatment of anterior and apical pelvic organ prolapse: Technical note with video demonstration.

Following transvaginal mesh interdiction, native tissue repair (NTR) emerged as the standard surgical approach for anterior pelvic organ prolapse (POP) requiring vaginal intervention, despite high recurrence rates with traditional methods. This study presents a novel NTR technique combining vaginal patch plastron (VPP) with anterior sacrospinous ligament fixation (SSLF-A) to address anterior and apical POP. Incorporating apical suspension during anterior repair reduces recurrence compared to non-apical procedures. The VPP technique involves creating a vaginal strip on the anterior colpocele, suspended bilaterally to the sacrospinous ligament (SSL) and arcus tendineus fasciae pelvis, secured with non-absorbable sutures. It can be paired with SSL hysteropexy or vault suspension for comprehensive support. Early results suggest enhanced anatomical stability and reduced relapse risk by addressing multicompartmental defects through a single vaginal approach. While demonstrating procedural safety and feasibility, further comparative studies are needed to evaluate this approach against existing techniques for advanced anterior-apical prolapse.