Sacrocolpopexy is a common surgical treatment for symptomatic pelvic organ prolapse. While traditionally reserved for women with recurrent or vaginal vault prolapse, sacrocolpopexy is becoming more common as a primary surgical option for women with prolapse. Suturing can be one of the most time-consuming portions (31-41 minutes) of a minimally invasive sacrcolpopexy. Any increase in operative time potentially adds to the cost and postoperative complications associated with prolonged anesthesia and steep Trendelenburg positioning.

Our objective was to demonstrate a novel vaginal attachment of mesh during minimally invasive sacrocolpopexy. The video follows a patient with pelvic organ prolapse who underwent robotic assisted sacrocolpopexy with a novel vaginal mesh attachment technique.

In this video we demonstrate a novel technique for vaginal mesh attachment during sacrocolpopexy using dissolvable anchors delivered with an articulating mesh fixation device.  We describe materials needed, setup, as well as opportunities for more efficient mesh attachment.  We demonstrate in detail anterior and posterior vaginal mesh attachment with this novel anchoring technique as well as relevant surgical anatomy.

Absorbable anchors provide a novel and potentially more efficient technique for vaginal mesh attachment.