Research Information System
34th Annual Congress of the European Society for Gynaecological Endoscopy (ESGE), İstanbul, Turkey, 19 - 22 October 2025, pp.1, (Full Text)
Background
To describe the surgical steps of laparoscopic Pectopexy without the use of a mesh.
Methods
Narrated surgical video. Local institutional review approval not required, patient consent was
obtained.
47-year-old, multiparous patient was admitted to hospital with abnormal uterine bleeding and a 6-
centimeter uterine fibroid. She also had pelvic organ prolapse and her POPQ score was as follows;
Aa: -1, Ba: +1, C: +2, Ap: -1, Bp: -2, D: -1.
Results
After routine laparoscopic hysterectomy and bilateral salpingo-oophorectomy, meshless Pectopexy
was performed to correct apical prolapse. Meshless Pectopexy can be performed safely by following
those steps: 1. Peritoneal incision from the right end of the vaginal cuff to the level of the right
pectineal ligament. 2. Identification of the pectineal ligament lateral to the medial umbilical ligament
on the right side. 3. Repetition of steps 1 and 2 on the opposite side. 4. Passing of a non-absorbable
monofilament polypropylene suture (Prolene 0, Ethicon Inc; Johnson & Johnson, Somerville, NJ, USA)
through the pectineal ligament and knotting on one side 5. Passing the suture through the vaginal
cuff two or three times and tying with sufficient tension. 6. Repetition of steps 4 and 5 on the
opposite side. 7. Closure of the parietal peritoneum with absorbable, knotless suture (V-locTM,
Covidien, Inc, Mansfield, Massachusetts).
Conclusions
Laparoscopic Pectopexy was developed as an alternative method to sacrocolpopexy. In the original
method, the cervix uteri or vaginal cuff is suspended to the bilateral pectineal ligament using a mesh.
The use of oak poses risks such as that of erosion. Some modifications of the original technique using
Mersilene tape or polyester sutures instead of a mesh to prevent erosion have been described.
However, data are limited. The meshless modification of laparoscopic Pectopexy with prolene
sutures is a safe and reproducible method, eliminating the risk of mesh erosion, especially in cases
with simultaneous hysterectomy.
https://player.vimeo.com/video/1085661196?autoplay=1