Laparoscopic Sacro-Colpopexy

Sacrocolpopexy

What is Sacrocolpopexy?

Sacrocolpopexy is a major surgical procedure to treat prolapse of the vault (top) of the vagina in women who have had a previous hysterectomy by fixing it to the sacrum using a graft or mesh.  First described in the late 1950’s, sacrocolpopexy is highly regarded for its effectiveness and durability in the treatment of vault prolapse.

What is Sacrohysteropexy?

In women with uterine prolapse, a procedure similar to sacrocolpopexy can be done to restore the uterus back to is normal place in the pelvis.

What is Sacrocervicopexy?

Some women who have undergone supra-cervical (also called subtotal) hysterectomy with the cervix left behind, the prolapse of the top of the vagina with the cervix attached can be restored back to its normal place similar to sacrocolpopexy.

How is the operation performed?

Traditionally, sacrocolpopexy is carried out through a large abdominal incision (laparotomy) under general anaesthesia. With advances in minimally invasive surgery, sacrocolpopexy can be carried out through ‘keyhole’ surgery using laparoscopic or robotic surgery, delivering benefits of less pain and quicker recovery compared to laparotomy.

What does Sacrocolpopexy/ Sacrohysteropexy/ Sacrocervicopexy involve?

All three procedures involve securement of a graft or mesh from the top of the vagina, the uterus or cervix to the ligament lying on the front of the sacrum using suture materials or tacking devices.

How successful is Sacrocolpopexy and how does it compare to other surgical options?

Based on Cochrane, a non-profit organization formed to facilitate evidence-based choices about health interventions (http://www.cochranelibrary.com), sacrocolpopexy delivers superior outcomes to transvaginal procedures such as sacrospinous ligament, uterosacral ligament and transvaginal mesh suspension. 

Reported long-term success rate varies from surgeon to surgeon, and ranges from 80 to 100%. At CARE, our long-term follow-up shows success for correction of uterine and vault prolapse over 95%.   

To obtain the best result, who should perform sacrocolpopexy?

According to Guidelines for Privileging and Credentialing Physicians for Sacrocolpopexy for Pelvic Organ Prolapse by the American Urogynecologic Society’s Guidelines Development Committee, published in Female Pelvic Med Reconstr Surg. 2013 Mar-Apr;19(2):62-5, sacrocolpopexy is a complex surgical procedure which should only be performed by surgeons with board certification or active candidacy for board certification in obstetrics and gynecology or urology who also have requisite knowledge, surgical skills, and experience in reconstructive pelvic surgery.

More information about sacrocolpopexy including colour illustration about this procedure is available at https://vcgmedia.objects.frb.io/ucurogyn/Sacrocolpopexy_IUGA_UroGyn.pdf