Modification of abdominal sacrocolpopexy using a suture anchor system

Abstract

Objective: To describe treatment of total vaginal vault prolapse with abdominal sacrocolpopexy using a new technique involving Prolene mesh (Ethicon, Somerville, New Jersey) and the Vesica PRESS IN Suture Anchor System (Boston Scientific, Watertown, Massachusetts).

Study design: We selected patients with new and recurrent vaginal prolapses that were not amenable to vaginal sacrospinous ligament suspension.

Results: The 11 patients treated with this modification had a speedy recovery, with no complications and a satisfactory result.

Conclusion: Use of the Vesica PRESS IN Suture Anchor System for placement of the suture in the mesh that suspends the vaginal vault from the L-5 or S-1 vertebra obviates the need for placement of multiple sutures into the longitudinal ligament of the vertebra. This minimizes the risk of damage to the presacral vessels, inferior vena cava and abdominal aorta. Therefore, this procedure retains the well-documented advantages of preserving the natural vaginal axis, maintaining coital function and offering a lasting solution to the problem of vaginal vault prolapse.