Laparoscopic Pectopexy is nowadays known as a novel alternative surgical procedure to treat pelvic organ prolapse (POP) by attaching the uterus to the pelvic side wall by using mesh and sutures. Although this technique has several advantages over traditional sacralcolpopexy, the potential recurrent risk still exists. Both advantages and disadvantages of laparoscopic pectopexy were analyzed in this study.

From 2019 to 2022, a total 34 patients with POP stage II to IV received uterus-preserving laparoscopic pectopexy. In this operation, the mesh was fixed to anterior cervix, and lateral parts of the Iliopectineal ligament. Besides, anterior/ posterior colporrhaphy and mid-urethral sling were accompanied if indicated. Post-operative follow-up ranged from 12 to 36 months. The clinical outcomes were reviewed and analyzed

All of the laparoscopic pectopexy were done successfully and there were no severe complications during or after the surgeries. Besides, minimal blood loss, short duration of operation times, catheterization and hospitalization were also known. The patients’ basic information, as well as peri-operative reports and post-operative outcomes were listed in the table (Table 1.) below. 
 In a follow-up of 2-3 years, it was found that 5 cases had failed (5/34, 14.7%), but only with recurrent stage II prolapse (leading point less then +1cm). Among them, 3 cases were in the apical region. Two of them had stage IV total prolapse before op, and all of them had the jobs requires heavy lifting. Detachment of apical fixation of mesh maybe the reasons for recurrence. Another 2 cases suffered from recurrent anterior prolapse, but all asymptomatic. No other complications such as pelvic pain, dysuria, denovo SUI, denovo constipation, or mesh erosion were found otherwise.

Laparoscopic pectopexy involves using bilateral mesh fixed to lateral parts of the Iliopectineal ligament in order to support the pelvic organs and reposition them to their proper location. According to our experience, there is still a risk of recurrence, especially in patients with stage IV prolapse and weight bearing jobs. Compared to traditional sacrocolpopexy, this surgery requires caution regarding suture placement and detachment of the cervix since it only involves fixation of the anterior cervix. However, it is still considered as an efficient surgical procedure due to low complication rate and quick recovery.

Laparoscopic pectopexy is a promising method for POP treatment. It uses the lateral parts of the iliopectineal ligament for a bilateral mesh fixation of the descended structures, so fewer intraoperative risks and potential long-term problems are expected. Due to simple technique, rare complication, and high efficacy, it can be considered as an alternative to other laparoscopic POP surgeries. However, strong apical fixation is indicated to prevent recurrence after this procedure.