Laparoscopic Lateral Suspension According to Dubuisson: Technical Video Guide with Tips and Tricks

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Female Pelvic Medicine and Reconstructive Surgery

Background:

• Pelvic organ prolapse (POP) affects a significant number of women, impacting quality of life.
• Surgical management of POP aims to restore pelvic anatomy and function.
• Laparoscopic Lateral Suspension (LLS) is a surgical technique for POP treatment.

Purpose of the Study:

• To illustrate key technical steps and refined strategies for Laparoscopic Lateral Suspension (LLS).
• To improve safety, precision, and reproducibility in LLS for pelvic organ prolapse (POP).

Main Methods:

• The video presents intraoperative laparoscopic footage of LLS procedures.
• Techniques include bladder suspension, accurate vaginal wall measurement, optimal mesh tailoring, and specific trocar use.
• A standardized, step-by-step process is detailed to enhance intraoperative control and reproducibility.

Main Results:

• Refined LLS techniques improve intraoperative control during dissection, mesh sizing, and retroperitoneal tunneling.
• The use of a Foley segment for bladder retraction and measurement offers a low-cost, effective strategy.
• Stepwise mesh deployment and peritoneal traction ensure safe and consistent suspension.

Conclusions:

• Laparoscopic Lateral Suspension (LLS) offers an alternative to laparoscopic sacral colpopexy, especially when promontory access is challenging.
• The presented refinements enhance reproducibility and intraoperative control in LLS procedures.
• These techniques contribute to safer and more consistent surgical outcomes for POP treatment.