Related Experiment Video
Updated: Sep 7, 2025
Development of a Uterosacral Ligament Suspension Rat Model
Published on: August 17, 2022
Anatomic identification of laparoscopic uterosacral ligament suspension: A step-by-step procedure
Yinluan OuYang1, Wanwan Xu2, Fan Li1
1Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, Zhejiang, People's Republic of China, 310006.
Introduction And Hyposthesis:
The uterosacral ligament (USL) is the main structure of physiological apical support, and USL suspension is one of the most commonly used methods for native tissue apical suspension. Structures surrounding the USL are complex, and the USL itself is difficult to identify, especially the sacral portion of the USL. Laparoscopy improves visualization, but exposure of the USL is still unsatisfactory.
Methods:
In this study, we report a simple method for exposing and suturing the USL laparoscopically, with step-by-step instructions, well-presented figures and videos. The key techniques are shown as follows: keeping tension on the USL with a uterine manipulator, dissecting the space medial to the USL, exposing the portion of the USL near the sacrum through the natural space, and then suturing it medially and connecting it directly to the posterior cervix.
Results:
95 consecutive patients have undergone this modified USLS and none had serious perioperative complication.
Conclusion:
In this way, the USL anatomy is exposed well, which may make placement of sutures in USL suspension safe and effective.
