Atlanta Center for Laparoscopic Urogynecology
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Laparoscopic Uterine Suspension
Laparoscopic And Minimally Invasive Procedures
Traditional medicine recommends removal of the uterus (hysterectomy) when there is uterine prolapse (fig. 1). In cases of severe uterine and vaginal prolapse a hysterectomy followed by vaginal wall reconstruction may still be the most beneficial therapy. However there are more women who are electing to keep their uterus especially in those whom the uterus is only mildly or moderately prolapsed. The decision to attempt uterine and vaginal support is made only after a full informed consent is made with the patient having the operation. One of the most important aspects of this surgery is the lack of long term data supporting its utilization in uterine and vaginal prolapse surgery.
Dr. Miklos and Dr. Moore will perform laparoscopic uterine suspension surgery in selected patients. The uterine support surgery that they perform is based upon restoration of the normal supportive endopelvic fascia. Drs. Miklos and Moore have never performed a uterine suspension surgery without correcting other vaginal prolapse defects present. It is their experience that anyone having a uterine suspension will most likely need a paravaginal repair, possibly a posterior repair and or a procedure for urinary incontinence.
There are many methods of uterine suspension including sacrospinous ligament suspension, abdominal Sacral Colpopexy (mesh between uterus and tailbone) and uterosacral ligament suspension. Dr. Miklos and Dr. Moore routinely perform the laparoscopic approach and/or utilizing mesh (fig 2) to suspend the uterus (sacrohysteropexy) or in some cases the uterosacral ligaments.
Fig 1 Uterine Prolapse
Fig 2. Laparoscopic Mesh Sacrohysteropexy: the uterus is suspended by attaching mesh
to the back of the uterus and then suturing the other end to the ligament on the sacrum (tailbone)
Laparoscopy Fig 3
Laparoscopic Procedure