Does the way hysterectomy is performed make a difference? How to prevent prolapse at the time of hysterectomy

Laparoscopic pelvic floor reconstruction requires a thorough understanding of pelvic floor anatomy. One can undertake reconstructive pelvic surgery only after attaining this knowledge of pelvic floor anatomy. Pelvic organ prolapse is the indication for more than 300,000 surgeries in the United States annually, at a cost of more than one billion dollars (1). The actual incidence of vaginal vault prolapse is unknown but it is thought to occur in 0.1% to 45.0% of patients who have undergone hysterectomy (2,3). Laparoscopic surgery provides excellent visualization, magnification of pelvic structures, reduced hospitalization, decreased pain and recovery time.