Laparoscopic duplication of the uterosacral ligaments following hysterectomy for stage III–IV apical pelvic organ prolapse

Different techniques have been proposed over the last decades to avoid the vaginal vault prolapse following hysterectomy for severe (stage III–IV) apical pelvic organ prolapse. In this scenario, the laparoscopic duplication of the uterosacral ligaments to the vaginal apex might represent a simple alternative procedure, associated with low morbidity and optimal surgical outcomes. In this paper, we present the preliminary results of 25 consecutive patients, who underwent total laparoscopic hysterectomy followed by uterosacral ligament duplication for stage III–IV apical pelvic organ prolapse. A detailed description of the surgical procedure is also provided.