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How to facilitate laparoscopic extraperitoneal suture?

To show a simplified technique of extraperitoneal laparoscopic suture. Step-by-step explanation of the technique using an educative video and pictures. This technique of extraperitoneal laparoscopic suture is highlighted through two laparoscopic procedures: a sacrocolpopexy (mesh fixation) for a pelvic organ prolapse and an ovariopexy after hysterectomy without adnexectomy (fibromatous uterus). This method avoids the need for repetitive use of the knot-pusher in performing extraperitoneal knots. Time saved in the operating room and limited gestures can theoretically contribute to decrease cost and improve safety. Although our intimate conviction goes in this direction, further studies are needed to better evaluate this procedure. Rehabilitating a process historically used during laparotomic procedures, this technique avoids iterative intra-abdominal gestures and expedites the knot-tying steps.

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