G-Mesh for Laparoscopic Pectopexy: A Single-center Evaluation of a Novel Technique for Apical Prolapse Repair.

Abstract

Apical prolapse, characterized by descent of the vaginal vault or uterus, continues to pose significant challenges in pelvic reconstructive surgery. Although laparoscopic sacropexy has long been considered the standard approach, it is often associated with defecatory, urinary, and mesh-related complications. Laparoscopic pectopexy, which anchors the suspension to the iliopectineal ligaments, has emerged as a safer and anatomically favorable alternative. This study evaluated the safety, feasibility, and anatomical and functional outcomes of a modified "G-mesh" laparoscopic pectopexy technique performed at a single tertiary-care center. A retrospective observational analysis was conducted on women who underwent the procedure between 2021 and 2025, assessing demographic characteristics, intraoperative details, and postoperative outcomes. Follow-up included POP-Q assessment, recurrence rates, and complication profile. The mean operative duration was 72 minutes with an average blood loss of 50 mL, and no major complications were recorded. Two minor intraoperative incidents-bladder wall thinning and vesicovaginal bleeding-were successfully managed laparoscopically. At 12-month follow-up, 13.3% of patients demonstrated mild prolapse recurrence, all managed conservatively with pelvic-floor rehabilitation. Overall, the G-mesh laparoscopic pectopexy technique appears safe, feasible, and associated with low morbidity and favorable anatomical outcomes. Further large-scale multicentric studies with extended follow-up are recommended to strengthen the evidence base for this technique.