Laparoscopic pectopexy for a case of vault prolapse

For over two decades, abdominal and vaginal approaches have been the mainstay for women presenting with vault prolapse. Among which sacrocolpopexy has been the procedure of choice. Despite its merits over other procedures, 19.5% of women undergoing Sacrocolpopexy complain of defecatory disorders like constipation due to possible irritation of the sympathetic nerve fibers in the pararectal space. To overcome this challenge, Bannerjee and Noe, in 2011, introduced the technique of laparoscopic pectopexy, where the mesh is anchored to the iliopectineal ligaments instead of the anterior longitudinal ligaments near the sacral promontory. The iliopectineal ligament is a crescent-shaped structure along the posterior side of the superior pubic ramus with good load-bearing capacity. Advantages of the laparoscopic approach include shorter hospital stay, faster recovery, improved pelvic symptoms, and quality of life. Here, we demonstrate a case of vault prolapse corrected via laparoscopic pectopexy.