Native tissue sacrospinous hysteropexy from an anterior approach.

Objective: The goal of urogynecologic surgeons is to pair patients with the most appropriate and effective surgery. Sacrospinous hysteropexy has become an increasingly utilized surgical option for uterovaginal prolapse repair. The primary aim of this video is to highlight the role that sacrospinous hysteropexy can have in prolapse repair and to demonstrate an anterior approach for this procedure.

Methods: We performed a literature review to provide general information on the efficacy, risks, and comparative benefits of sacrospinous hysteropexy. Our video demonstrates the key steps in performing a sacrospinous hysteropexy procedure from an anterior approach including method of dissection, suture fixation to the sacrospinous ligament, and cervical suspension.

Results: Sacrospinous hysteropexy has generally been found to be an effective option for uterovaginal prolapse repair in properly selected patients. The demonstrated approach integrates sacrospinous ligament fixation with an anterior colporrhaphy.

Conclusions: Data and experience to date on sacrospinous hysteropexy are largely based on a posterior approach for access to the sacrospinous ligament. This surgical video demonstrates an anterior approach to sacrospinous hysteropexy that is not well characterized in the literature.