Laparoscopic Ventral Mesh Rectopexy and Lateral Suspension for Multicompartment Prolapse: A Video Vignette

Pelvic floor disorders are a group of conditions caused by the failure of the pelvic floor muscles to properly support the pelvic organs. They can affect the urinary, gynecological, and anorectal organs and require a multidisciplinary approach. Pelvic organ prolapse affects 25% of women, and multicompartment prolapse can be found in 10-55% of patients.¹ Laparoscopic ventral mesh rectopexy (LVMR) is a nerve-sparing technique introduced by Consten et al.² in 2004 for pelvic floor disorders, and its efficacy has been supported by many studies over the past two decades. For apical prolapse, the widely accepted approach is laparoscopic sacrocolpopexy. However, in patients wishing to preserve the uterus, lateral suspension is a safe and effective alternative³ with comparable functional outcomes and a lower risk of complications.⁴

A 39-year-old woman presented with complaints of obstructed defecation syndrome, stress incontinence, and vaginal flatulence. The patient had a medical history of three vaginal deliveries and bilateral salpingo-oophorectomy. Informed consent for the use of patient data is obtained from all individuals who present to our university hospital. A copy of this patient’s consent form is provided in the appendix. Defecography revealed an Oxford grade 3 rectal prolapse, an anterior rectocele, moderate middle compartment prolapse, and a small cystocele. The pelvic organ prolapse quantification stage was 2. A combined LVMR and lateral suspension were performed, restoring all compartments through a single transabdominal approach (Video 1).