Laparoscopic vaginal vault lateral suspension: a promising alternative to laparoscopic sacrocolpopexy for post-hysterectomy vault prolapse management

Abstract

Post-hysterectomy vaginal vault prolapse is a common complication. There is an impact on the quality of life of patients after undergoing different types of hysterectomies, due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanisms for the uterus and vagina is important to minimize the risk of post hysterectomy occurrence of vault prolapse, and also to make the right choice of the corrective procedure for vaginal vault prolapse. The gold standard for surgical management of post-hysterectomy vaginal vault prolapse has been sacrocolpopexy. However, with the procedure there is risk of accidental trauma to the pre-sacral venous plexus. In this article we present our technique of laparoscopic vaginal vault lateral suspension (LVVLS) with fixation to anterior superior iliac spine (ASIS). This technique offers the same benefit as sacrocolpopexy but without the risk of haemorrhage from the pre-sacral venous plexus, potential nerve injury, ureteral injury, bladder injury and rectal injury.