Laparoscopic Pectouteropexy: Alternative Technique for Uterine Preservation

Study objective: To show an alternative technique of laparoscopic pectouteropexy for uterine preservation in young women.

Design: A step-by-step explanation of the technique using videos (educative video).

Setting: In recent years, uterine preservation surgery for pelvic organ prolapse has become more popular. Sacrouteropexy is traditionally performed for prolapsus surgery, but the procedure continues to be associated with an increased length of stay, increased analgesic requirements, small bowel obstruction, ileus, and de novo stres urinary incontinence. An alternative technique of laparoscopic pectouteropexy has been developed for the preservation of fertility in younger women; this technique uses lateral parts of the iliopectineal ligament for a bilateral mesh fixation of the descended structures and provides strong apical support.

Conclusion: The iliopectineal ligament is far from the ureter, intestine, sigmoid, and presacral veins during surgery, so the iliopectineal ligament is in a safe anatomic zone for uterine preservation surgery. Laparoscopic pectouteropexy might be an alternative technique for preservation of the uterus in young patients.