Laparoscopic Non-Mesh Cerclage Pectopexy with Uterine Preservation for Pelvic Organ Prolapse

A laparoscopic non-mesh cerclage pectopexy with a uterine preservation is developed to treat poor patients who wish to preserve the uterus, which eliminate mesh lowering complications. The usage of synthetic mesh for support in POP surgery cause mesh related complications, increasing patient suffering and medical expenses. LNMCPUP integrates cervical cerclage and laparoscopic pectopexy without using mesh, resulting in a form uterine suspection, while also eliminating the loss of mass explosion and lowering healthcare costs.

To begin the laparoscopic bilateral salpingo-oophorectomy, use an electrosurgical tool to coagulate the round ligament and sever it. Open the vesical uterine recursion peritoneum to expose the uterine artery. To perform cervical isthmic cerclage, start at the four o'clock position on the right side and proceed counterclockwise.

Continue in a circular motion around the cervix until reaching the starting point. Expose the ileal pectineal ligament and make an incision in the peritoneum. Using surgical tools, detach the surrounding soft tissue between the lateral umbilical ligament and the round ligament.

Using a permanent suture of size two, suture, legate, and attach the round ligament to the cervical isthmus. Embed the permanent suture into the round ligament ending at the ileal pectineal ligament. Insert the stitch through the ileal pectineal ligament and confirm suspension without tension.

Next, repeat the process on the other side of the pelvis. Finally, perform reperitonealization. The laparoscopic non-mesh cerclage pectopexy with uterine preservation was performed successfully in 14 patients with an objective success rate of 100%The subjective success rate assessed with the patient global impression was 92.86%No complications were reported during the follow-up period, which had an average duration of approximately 19.71 months.