Laparoscopic Paravaginal Repair: A New Technique Using Mesh and Staples

OBJECTIVE: To describe a new technique of paravaginal repair, utilizing Prolene mesh and a hernia stapler. METHODS: We conducted a retrospective case series review of 12 patients who underwent laparoscopic bladder neck suspension, who were clinically diagnosed with cystocele caused by paravaginal defects. The patients had paravaginal repair performed utilizing mesh and staples. Prolene mesh was stapled to the vaginal margin and suspended from Cooper's ligament. The technique is described and demonstrated in a line drawing. RESULTS: All procedures were completed without incident. No additional blood loss or other morbidity has been identified. Results were evaluated by history and examination. Subjective improvement was noted in 10 of 11 patients. Objective improvement was found in 9 of 11. Adverse effects were not identified. One patient was lost to follow-up. CONCLUSION: This procedure is potentially an alternative method for performing the paravaginal repair by a minimally invasive route. We feel that this makes the procedure potentially safer, quicker, and more accessible to laparoscopic surgeons but with equal effectiveness. Larger series with more rigorous analysis are required before the procedure can be evaluated adequately and recommended for general use.