[Laparoscopic sacrocolpopexy: technical overview and standardized steps]

Introduction: Due to its low recurrence rate and the advantages of minimally invasive surgery, laparoscopic sacrocolpopexy has become one of the most commonly performed procedures for the treatment of apical uterovaginal prolapse. Several variations of the surgical technique exist, with the choice often reflecting the surgeon’s individual experience. However, the benefits of standardized surgical steps are indisputable in ensuring proper adaptation and safe execution of the procedure. Objective:This study aims to present the main surgical steps of laparoscopic sacrocolpopexy as applied in our clinical practice, based on the available literature and current evidence, and to analyze our clinical data. Method: Following the relevant literature, international guidelines, and our experience, the procedure was standardized into the following steps: (1) exposure of the surgical field, (2) dissection of the promontory, (3) pararectal dissection, (4) rectovaginal dissection, (5) vesicovaginal dissection, (6) supracervical hysterectomy (when indicated and the uterine corpus is present, and removal of the cervix is not justified), (7) mesh fixation to the vagina, (8) mesh fixation to the promontory, (9) peritoneal closure, (10) removal of the uterine corpus from the abdominal cavity. Results: We analyzed data from 30 laparoscopic sacrocolpopexy procedures performed at the Department of Obstetrics and Gynecology, University of Debrecen, between September 2022 and April 2023. No major intraoperative or postoperative complications occurred; deviation from the planned surgical type was required in three cases. After 6 weeks, the majority of patients reported a marked improvement in subjective prolapse symptoms. Two cases of symptomatic recurrence were identified: one managed conservatively, and one required surgical correction. No cases of de novo stress urinary incontinence were observed. Conclusion: Laparoscopic sacrocolpopexy may represent an effective surgical option for the treatment of apical uterovaginal prolapse. The application of standardized surgical steps may improve procedural safety, facilitate surgical training, and contribute to reduced operative time. Orv Hetil. 2025; 166(31): 1217–1223.