Prevalence of pelvic organ prolapse is 41%-50%. It negatively impacts quality of life due to associated urinary, ano-rectal, and sexual dysfunction. This educational video reviews pelvic support levels and pelvic organ prolaspe, demonstrates laparoscopic McCall’s culdoplasty technique, and discusses possible intra- and post-operative complications.
Design: This video uses still images, video footage, and narration to review pelvic organ prolapse and laparoscopic McCall’s culdoplasty. The technique is presented in five steps, addressing the advantages of this approach and possible surgical complications
Setting: Tertiary hospital OR
Patients or Participants: Patients undergoing total laparoscopic hysterectomy and prophylactic laparoscopic McCall’s cordocentesis
Interventions: Prophylactic laparoscopic McCall’s culdoplasty
Measurements and Main Results:
Vaginal apical suspension is recommended at the time of hysterectomy to prevent future vault prolapse. The five steps of Laparoscopic McCall’s include (1) marking uterosacral ligaments, (2) vault closure with interrupted angle sutures, (3) vault hemostasis, (4) McCall’s placement and (5)
Conclusion:
Prophylactic McCall’s culdoplasty at the time of hysterectomy is superior at preventing future prolapse compared with other techniques. Laparoscopic approach is efficient, safe and can be easily learned by surgeons.
Shishkina, A*1, Shivji, A2, Miazga, E3, Simpson, A2, Shore, E2. 1Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; 2Obstetrics and Gynecology, Unity Health – St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada; 3Obstetrics and Gynecology, Unity Health – The Credit Valley Hospital, University of Toronto, Toronto, ON, Canada