2032 Laparoscopic Pectopexy for Prolapse Repair

Video Objective To study the efficacy and safety of Laparoscopic Pectopexy Setting Tertiary care center Interventions Since October 2015 till March 2019 – 50 cases of pectopexy have been done. Most of the cases have been of Hysteropexy in age group of 27-36 years (mean age 32 years) and 7 cases of Laparoscopic Subtotal Hysterectomy in age group of 42- 67 years (average age 54.5). And 4 cases of vault prolapse. Our technique combines site specific repair with mesh augmented repair. Anterior pelvic support is pubocervical fascia which is dissected after pushing the bladder down, and plicated with 1-0 polyester suture. After plication of Pubocervical fascia a 15 cm by 3 cm size mesh is applied over the cervical stump / lower uterine segment / vaginal vault in the center. The lateral attachments of the mesh are fixed over to the iliopectineal ligament on both the sides. Iliopectineal ligament is the posterior prolongation of the Cooper's ligament. For a global repair and long term good results plication of the uterosacral ligaments is done. Conclusion Pectopexy appears to be a new, useful tool in the armamentarium of gynecological endoscopists for hysteropexy in patients desirous of further child bearing as it gives bilateral support at level of pericervical ring. It is also applicable for vault prolapse repair and after Laparoscopic Subtotal Hysterectomy for vault suspension.