Design: It is Retrospective in nature, patients were interviewed at post-operative 6 weeks and then 3 months, 6 months and 1 year post operatively.

Setting: Conducted at a tertiary referral center specializing in laparoscopic pelvic floor repair.

Patients or Participants: All patients were in the age group 45-76 year, BMI, 16-40, with complaints of vault prolapse, primary or recurrent after failed Sacro-Colpopexy or site- specific- repair .

Interventions: Patients laid in modified lithotomy position, under general anesthesia. Laparoscopic pectopexy done after opening the peritoneum covering the vault. A Polypropylene mesh with a 6cm by 4cm centre piece, and side limbs of 2.5cm, width, was fashioned out from a 15 by 15 cm mesh. The centre piece was fixed to the vaginal apex and the side limbs were fixed to the pectineal ligaments, using two braided polyester sutures.

Measurements and Main Results: The case presented in the video had a pectopexy after a failed site specific repair and burch colposuspension done seventeen years back. Good functional and anatomical correction achieved at the end. For other cases the follow up period ranges from 6 months to five years. No major complication was noted. Minor, lower dragging pain persisted in initial 3-4 weeks. Patients were satisfied with anatomical and functional correction achieved.

Conclusion: Sacrocolpopexy is the gold standard, but our study points that pectopexy a relatively newer procedure, is also a safe, feasible and effective way to treat vault prolapse.