This video demonstrate Sacrocolpopexy is an operation to correct uterine prolapse or to correct vaginal vault prolapse in women who have had a hysterectomy. This surgery offers long-term treatment of apical prolapse with success rates greater than 80 percent. sometimes can be treated in the office but may require more surgery.

Laparoscopic hysterectomy with sacrocolpopexy is an advanced minimally invasive surgical procedure widely performed for the treatment of uterine prolapse and advanced pelvic organ prolapse. At the World Laparoscopy Hospital (WLH), this procedure represents a combination of cutting-edge laparoscopic technology, structured surgical training, and evidence-based clinical protocols. It is considered one of the most effective reconstructive surgeries for restoring pelvic anatomy and improving quality of life in women suffering from symptomatic prolapse.

Uterine prolapse is a common gynecological condition in which the uterus descends into or outside the vaginal canal due to weakening of pelvic floor support structures. Factors such as childbirth trauma, aging, menopause, chronic cough, obesity, and connective tissue weakness contribute to pelvic floor failure. When conservative management fails, surgical correction becomes necessary.

Laparoscopic hysterectomy removes the uterus through keyhole surgery, while sacrocolpopexy suspends the vaginal vault to the sacral promontory using surgical mesh, restoring normal vaginal axis and pelvic support. Laparoscopic sacrocolpopexy is considered the gold standard for apical prolapse repair due to high long-term success and durability.

Role of World Laparoscopy Hospital

World Laparoscopy Hospital is internationally recognized for laparoscopic and robotic surgery training and advanced clinical care. The institution emphasizes:

• Standardized laparoscopic surgical techniques

• Evidence-based patient management

• Hands-on simulation and live surgical exposure

• Focus on patient safety and minimal invasive excellence

At WLH, surgeons are trained to perform combined hysterectomy and sacrocolpopexy using precise anatomical dissection and advanced laparoscopic suturing techniques, improving patient outcomes.

Indications for Laparoscopic Hysterectomy With Sacrocolpopexy

This combined procedure is indicated in:

• Symptomatic uterine prolapse (Stage II–IV)

• Uterine prolapse with cystocele or rectocele

• Recurrent prolapse after previous surgery

• Women not requiring uterine preservation

• Associated pelvic floor defects needing durable repair

Studies show that combining hysterectomy with laparoscopic sacrocolpopexy can provide better objective and subjective outcomes compared to some uterus-preserving procedures, without increasing complication rates.

Surgical Technique (Overview)

1. Patient Positioning and Port Placement
Patient is placed in lithotomy with steep Trendelenburg. Typically 4–5 laparoscopic ports are inserted.

2. Laparoscopic Hysterectomy

• Dissection of uterine ligaments

• Securing uterine vessels

• Removal of uterus (total or supracervical depending on case)

3. Sacrocolpopexy Procedure

• Exposure of sacral promontory

• Mesh attachment to vaginal vault or cervix

• Mesh fixation to anterior longitudinal ligament of sacrum

• Peritoneal closure to cover mesh

This reconstructive approach maintains normal vaginal length and axis, allowing good postoperative sexual function.

Advantages of Laparoscopic Approach

Compared to open surgery, laparoscopic sacrocolpopexy offers:

• Smaller incisions and minimal scarring

• Less blood loss

• Faster recovery and shorter hospital stay

• Reduced postoperative pain

• Lower infection risk

• Early return to daily activity

Minimally invasive sacrocolpopexy procedures demonstrate success rates often exceeding 90% in many studies.

Clinical Outcomes and Success Rates

Evidence supports excellent anatomical and functional outcomes:

• Subjective cure rate around 93%

• Objective cure rate up to 98% in some studies

• Significant improvement in quality of life and sexual function

• Very low apical recurrence rates

These outcomes highlight the procedure as a durable solution for pelvic organ prolapse.

Long-term follow-up studies also show anatomical success rates around 94–95% with low recurrence and high patient satisfaction.

Risks and Complications

Although generally safe, potential risks include:

• Injury to bladder, bowel, or ureter

• Bleeding or infection

• Mesh-related complications such as erosion

• Thromboembolism

• Persistent pelvic pain

Mesh complications are uncommon but may require additional treatment or surgery in rare cases.

Postoperative Recovery

Typical recovery features include:

• Hospital stay: 1–3 days (laparoscopic)

• Return to normal activity: 4–6 weeks

• Avoid heavy lifting initially

• Pelvic floor rehabilitation if needed

Gas pain and abdominal bloating may occur temporarily due to laparoscopic insufflation.

Why This Procedure Is Preferred Today

Modern urogynecology favors laparoscopic sacrocolpopexy because:

• It restores normal pelvic anatomy

• Provides long-term durability

• Preserves vaginal function

• Offers minimally invasive recovery

• Shows consistent high success in clinical trials

Evidence also shows very low recurrence and reoperation rates in combined hysterectomy-sacrocolpopexy procedures.

Conclusion

Laparoscopic hysterectomy with sacrocolpopexy represents a milestone in minimally invasive gynecologic surgery. At World Laparoscopy Hospital, this procedure is performed using advanced laparoscopic techniques, ensuring excellent anatomical restoration, durable prolapse correction, and rapid patient recovery. With success rates exceeding 90% and strong long-term outcomes, this procedure continues to be regarded as the gold standard for managing uterine and apical pelvic organ prolapse.