New Laparoscopic Technique of Hysteropexy for Uterine Retrodisplacement: Bologna Technique

Abstract

Study objective: To show a new laparoscopic technique of hysteropexy for uterine retrodisplacement (retroversion and/or retroflexion).

Design: Narrated step-by-step explanation of the Bologna hysteropexy technique using descriptive text and an educational video.

Setting: Tertiary referred center of minimally invasive gynecology, Sant'Orsola Hospital, Bologna University.

Interventions: The Bologna hysteropexy is proposed as an additional procedure after surgical laparoscopic interventions for benign gynecologic disease. The technique consists of 2 semicontinuous absorbable sutures (Biosyn monofilament no. 1 [Covidien, Mansfield, MA] with 2/3 inch diameter needle, 36 mm) suspending the uterus to the anterior abdominal wall, through the plication and shortening of round ligaments. A knot is tied intracorporeally between the 2 free ends of the semicontinuous sutures, drawing a V shape figure and resulting in uterine ventrosuspension.

Conclusion: The Bologna technique hysteropexy is simple and quick to perform. It is effective in suspending the uterus in anteverted and anteflexed positions at 6-month ultrasound follow-up. No perioperative complications were recorded. It can be done with a standard surgical suture-passer and does not add additional cost to surgery. Furthermore, an absorbable suture is desirable for fertile women.

Keywords: Hysteropexy; Laparoscopy; Uterine retrodisplacement.