ABSTRACT
Autologous Fascia Lata (AFL) provides a fairly robust portion of connective tissue for reconstructive surgery. Management of mesh complications in pelvic floor surgery remains complex and utilising an AFL graft at abdominal sacrocolpopexy for apical prolapse in patients who may not be suitable for mesh procedures is a reasonable alternative. The laparoscopic pectopexy presents a new, promising and safe method for prolapse surgery. Long-term multicentre studies are required to provide robust data on this technique. The challenges and complications associated with mesh attachment to the sacral promontory at sacrocolpopexy have been described, and the Laparoscopic Lateral Suspension procedure represents an additional option for avoiding dissection at the promontory. Vaginal natural orifice transluminal endoscopic surgery brings the novel option of an abdominal procedure without any incisions. The procedure involves harvesting the AFL using a minimally invasive technique that has a low morbidity and then attaching the graft onto the vagina in a similar manner to the synthetic mesh sacrocolpopexy.
