Laparoscopic surgery for pelvic floor disorder

Lee, Yoon S

Abstract

Pelvic organ prolapse(POP) is a major health care problem. Up to 50% of parous women have some degree of pelvic organ prolapse although only 10?20% are symptomatic. The first line of treatment is surgical repair. Many surgical procedures have been described to correct pelvic organ prolapse. The majority of these procedures are performed either vaginally or abdominally, or with a combined abdominovaginal approach. With recent advancements of laparoscopic instruments and surgical techniques, interest in laparoscopic treatment of pelvic organ prolepse has surged. Beyond the well-known advantages of laparoscopy - less postoperative discomfort, shorter hospital stay, the laparoscopic approach offers the superior visualization of the pelvis, thereby allowing better exposure of the pelvic floor anatomy and more exact identification of the defect. Moreover, laparoscopic surgery provides a magnified view of the operative field and enables to perform an easier and more precise dissection. This enhances the identification of pelvic floor defects and allows more precise suture placement and improved correction of specific site defects. Laparoscopic pelvic floor repair is an effective procedure and enables to combine the advantages of laparotomy with the low morbidity of the vaginal route. This article reviews pelvic support anatomy and various laparoscopic surgical techniques currently available for reconstructive pelvic surgery.