Laparoscopic and Robotic Approaches to Apical and Vaginal Vault Suspension

Pelvic organ prolapse (POP) is often described as a herniation of the pelvic organs toward the vaginal walls. It is further divided into different categories based on the anatomical location of the herniation to include anterior, apical, and posterior prolapse. Apical prolapse is further described as the descent of the uterus and cervix or vaginal vault in posthysterectomy cases toward the hymen. This chapter will focus on the treatment of apical prolapse using laparoscopic techniques with or without robotic assistance. The two techniques specifically discussed are high uterosacral ligament suspension (HUSLS) and sacrocolpopexy.