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
Laparoscopic pectopexy has emerged as a novel alternative to sacrocolpopexy in the surgery of apical
prolapse, especially in cases where avoiding mesh-related complications is a priority. Originally
introduced by Banerjee and Noé (1) using mesh for fixation to the pectineal ligaments, the technique
has evolved toward mesh-free adaptations due to reports of erosion, pain, and other long-term
complications (2,3). Minimally invasive approaches, including single-port laparoscopy, have further
advanced the technique by reducing surgical trauma and enhancing cosmetic outcomes.
Methods
We present the first reported case of mesh-free single-port laparoscopic pectopexy performed in a
52-year-old woman with stage 4 uterine prolapse and a suspected 10 cm uterine leiomyoma. The
procedure began with resection of a concomitant 8 cm umbilical hernia, followed by the insertion of
a V-port through the hernia site. A total laparoscopic hysterectomy was performed, after which the
uterus and adnexa were removed via the single port. Meshless pectopexy was then initiated. The
vaginal cuff was manipulated transvaginally, and non-absorbable 2-0 polyester sutures were placed
through the cuff without penetrating the mucosa. The peritoneum was dissected to expose the
pectineal ligaments bilaterally, taking care to identify and preserve the iliac vessels. The sutures were
passed through the ligaments and tied intracorporeally without tension. The peritoneal defect was
closed using a barbed absorbable suture to prevent potential bowel entrapment.
Results
now.
Conclusions
Mesh-free single-port laparoscopic pectopexy is a promising technique that combines the safety of
mesh avoidance with the advantages of minimally invasive surgery. While our initial outcome was
favourable, consistent with existing literature (4–7) further prospective studies are needed to
validate the long-term efficacy and reproducibility of this approach.
References:
1. Banerjee C, Noé KG. Arch Gynecol Obstet. 2011;284(3):631–
2. Bakir MS, et al. Gynecol Minim Invasive Ther. 2020;9(1):42.
3. Obut M, et al. Gynecol Minim Invasive Ther. 2021;14;10(2):96-103.4.
4. Erdem B, et al. Int Urogynecology J. 2025;1;
5. Rovner E, et al. Neurourol Urodyn. 2020;39 Suppl 3:S132–9.
6. Aleksandrov A, et al. Facts Views Vis ObGyn. 2021;13(2):179–81.
7. Biyik I, et al. Gynecology and Minimally Invasive Therapy. 2025 (Article in press)
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