Laparoscopic sacropexy (sacrocolpopexy) is a minimally invasive surgical procedure used to correct pelvic organ prolapse, particularly prolapse of the vaginal vault or uterus. The procedure involves using a supportive mesh to suspend the vagina (or uterus) to the sacrum (the lower part of the spine), restoring normal pelvic support. It is performed using a laparoscope and specialised instruments inserted through small incisions in the abdomen, avoiding the need for a large open incision.

The suitability of laparoscopic sacropexy depends on several individual factors, including the type and severity of prolapse, previous pelvic surgeries, overall health, and the patient’s future reproductive or anatomical goals.

When is Laparoscopic Sacropexy Considered?

Laparoscopic sacropexy may be considered for women with conditions such as:

• Vaginal vault prolapse following a previous hysterectomy.
• Uterine prolapse, in cases where uterus-preserving suspension is planned.
• Recurrent prolapse after previous prolapse repair.
• Symptomatic pelvic organ prolapse causing a sensation of vaginal bulge, pressure, or discomfort.
• Prolapse affecting bladder or bowel function.
• Cases where a durable, long-term surgical repair is preferred.

Before recommending the procedure, the doctor may evaluate:

• The type, degree, and site of prolapse.
• Previous pelvic or vaginal surgical history.
• Overall health and fitness for surgery.
• Bladder and bowel function, and any associated symptoms.
• Whether the uterus is to be preserved or removed at the same time.
• Alternative treatment options, including non-surgical management, where applicable.

A detailed evaluation helps determine whether laparoscopic sacropexy is a suitable and safe option compared to other approaches for prolapse repair.

What Happens During Laparoscopic Sacropexy?

Before the procedure, the doctor reviews the patient’s medical and surgical history and conducts a detailed pelvic examination, along with relevant imaging where required. The procedure is performed under general anaesthesia.

During surgery, a few small incisions are made in the abdomen, through which a laparoscope and specialised instruments are inserted. A surgical mesh is attached to the vaginal vault (or uterus, if being preserved) and then fixed to the sacrum, creating a supportive structure that restores the normal position of the pelvic organs. If required, additional procedures, such as hysterectomy or repair of associated bladder or bowel prolapse, may be performed at the same time.

The exact surgical technique depends on the type and extent of prolapse, whether the uterus is preserved, and the surgeon’s clinical assessment.

Recovery After Laparoscopic Sacropexy

Recovery after laparoscopic sacropexy is generally quicker than open surgical repair, owing to the smaller incisions involved. Patients are generally advised to follow their doctor’s postoperative instructions carefully.

Important aspects of recovery may include:

• Keeping the small incision sites clean and following wound-care instructions.
• Taking prescribed medications for pain relief and infection prevention.
• Gradually resuming daily activities while avoiding heavy lifting or strenuous exertion for the recommended period.
• Avoiding activities that increase abdominal pressure until cleared by the doctor.
• Attending scheduled follow-up appointments.
• Discussing when it is appropriate to resume sexual activity.

Your doctor will provide personalised guidance based on your recovery and overall health.

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