Editorial board editor-in-chief

Fig. 1.
Mesh was inserted into the peritoneal cavity using the 5 mm trocar.
1. Group A
The irst stage in this group was the LSH procedure with or without 
bilateral adnexectomy. The uterine corpus was sectioned at the 
level of the isthmus above the uterosacral ligaments, using the 
monopolar-hook coagulator. In order to facilitate the placing of the 
mesh, the rectovaginal space was dilated between the uterosacral 
ligaments. Subsequently, the 50mm long part of the mesh was 
inserted into the tunnel and ixed to the vaginal ibromuscularis 
tissue with no. 0 vicryl, using the laparascopic technique. On 
the other hand, in the case of the rectocoele patient mesh was 
attached to the vaginal ibromuscularis laprascopically, in addi
-
tion, to the vaginal approach.
The mesh was ixed superiorly to the cervical stump and 
onto each of the uterosacral ligaments, similar to the McCall 
procedure. The branches of the mesh were then lead out thru 
the trocar’s tunnels, below the fascia of the rectus and oblique 
muscles and along each of the round ligaments. The branches 
of the mesh were covered with peritoneum and part of the round 
ligament. Then they were attached to the muscle fascia using 1 
or 2 stitches of no. 1 Ticron surgical threat.
2. Group b
The main procedure in this group was the TLH, with or without 
adnexectomy. The irst stages of TLH were similar to those in 
LSH. At the level of the uterine vessels, the parametria was 
coagulated and removed. The uterus was then amputated from 
the vaginal fornices using a monopolar-hook coagulator. The 
incision of the vaginal fornices was performed along the vis-
ible margin of the sealant cap. Subsequently, the uterus was 
pulled out vaginally and the vagina was closed with continuous 
sutures. Consequently, the uterosacral ligaments were located 
and the area between them was dissected. The mesh was then 
attached to the vaginal stump. The next stages were similar to 
those described for Group A.
In the case of the rectocole, mesh was attached to the vaginal 
ibromuscularis using the vaginal approach with the aid of the 
laparascopic technique, as was done in Group A.
200 mm
150 mm
20 mm
10 mm

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T
elema
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Laparoscopic colpopexy technique…
3. Group C
Patients in this group have had a previous hysterectomy. Mesh 
placing was performed similar to that as in Group B. In the case 
of the rectocele, we attached the mesh to the vaginal ibromus
-
cularis membrane using the vaginal approach and, as in Group 
B, it was done laparoscopically.