ABSTRACT
Historical improvements on sacro- and cervicocolpopexy deemed it the “gold standard” of repair for the vaginal apex. Addison suggested distribution of mesh over as wide a portion of the vagina as possible using multiple sutures. Few changes have been made to this already effective technique; however, one of the most beneficial recent advancements has been the successful conversion to a minimally invasive surgical procedure due to technological advancements in imaging, monitors, and better laparoscopic instruments. Despite the success of early surgeon adopters, the steep learning curve has hindered many gynecologists from incorporating this technique into their armamentarium. Robotic technology, discussed elsewhere in the text, may prove to be the pivotal enablement to overcome the technical challenges.
