How to facilitate laparoscopic extraperitoneal suture?

Abstract

To show a simplified technique of extraperitoneal laparoscopic suture. Step-by-step explanation of the technique using an educative video andpictures. This technique of extraperitoneal laparoscopic suture is highlighted through two laparoscopic procedures: a sacrocolpopexy (meshfixation) for a pelvic organ prolapse and an ovariopexy after hysterectomy without adnexectomy (fibromatous uterus). This method avoidsthe need for repetitive use of the knot-pusher in performing extraperitoneal knots. Time saved in the operating room and limited gestures cantheoretically contribute to decrease cost and improve safety. Although our intimate conviction goes in this direction, further studies are neededto better evaluate this procedure. Rehabilitating a process historically used during laparotomic procedures, this technique avoids iterative intraabdominalgestures and expedites the knot-tying steps. (J Turk Ger Gynecol Assoc 2018; 19: 235-40)