ABSTRACT

Laparoscopic anterior colporrhaphy begins with dissection of the vesicovaginal space. The vesicouterine reflection of peritoneum is opened transversely. This is facilitated by elevation of the vault with a sponge on a long forceps or a long retractor. The pubocervical fascia is then freed from the bladder, with the dissection carried out distally to the lower end of the anterior prolapse. The lateral extent of the dissection is dependent on the size of the anterior prolapse.