Uterine Suspension in Laparoscopic Surgeries 

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LAPAROSCOPIC (CLOSED SURGERY) CORRECTION OF GENITAL PROLAPSE: (LAPAROSCOPIC SACROCOLPOPEXY)

Uterine prolapse is one of the most common diseases and its treatment is surgery. In patients with prolapsed uterus, the uterus and prolapsed organs are suspended on the pelvic wall or on the sacral bone without removing the uterus. In the past, these surgeries were performed by opening the abdomen. The surgeries performed by opening the abdomen have been abandoned due to the disadvantages such as incision, high blood loss, excessive pain, long length of hospital stay and late time to return to work. Instead of open surgery, closed surgeries (laparoscopy) are now used and recommended in gynecology.

Cuff prolapse is the prolapsed vaginal vault, and the condition occurs after the removal of the uterus (hysterectomy). In some patients, the vaginal vault prolapses out of the vagina after hysterectomy, and in advanced cases, the vagina turns inside out like a balloon and protrude outside. The prolapsed vagina pulls down the bladder at the back and the last portion of the large intestine (rectum). The primary treatment of this condition is surgery. In addition to correction of the vaginal vault, the bladder and rectum should also be corrected in the surgery.

In vaginal vault prolapse, there are multiple surgical options, and the most appropriate surgery should be selected for the patient.

In recent years, closed surgeries (laparoscopy) are preferred because of the advantages such as absence of incision, minimal blood loss, early discharge and early return to work. In laparoscopic surgeries, we fix a mesh made of suture materials to the vaginal vault and uterus, and pass this under the peritoneum and place it by fixating in front of the bone behind the pelvis, called the sacrum. After the surgery, the patient is usually hospitalized for one day and returns to daily activity and work in a short time. The success rate of this surgery is quite high (above 90%). If the patient has urinary incontinence, it is also corrected with a short operation in the same session.