Laparoscopic management of pelvic organ prolapse

Until recently, most major gynecologic surgery was performed either vaginally or by laparotomy. In the last decade, surgeons have explored laparoscopic access for many gynecologic surgical disorders. Pelvic reconstructive surgery can be performed laparoscopically but demands a high skill level especially in suturing. Initial reports for laparoscopic bladder neck suspension for genuine stress urinary incontinence are encouraging but lack long term follow-up. The literature contains only a few case studies addressing pelvic support procedures. In this review we present our methods for laparoscopic management of different types of pelvic floor support defects. We view laparoscopy as a method of access rather than a procedure. We present laparoscopic techniques that do not modify the surgical procedures that have been validated by conventional surgery. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.