A modified minimally invasive technique for pelvic organ prolapse: transvaginal extraperitoneal single-port lateral suspension

Objective This retrospective comparative cohort study aimed to evaluate an improved transvaginal extraperitoneal single-port lateral suspension procedure for the treatment of anterior compartment prolapse and paravaginal defects while preserving the advantages of minimally invasive surgery and maintaining abdominal wall esthetics. Methods A retrospective comparative cohort study was performed on 43 cases treated in our hospital. Twelve patients who underwent the improved lateral suspension procedure were included in the improved group, whereas 31 patients who underwent traditional lateral suspension served as the control group. Patients in each group underwent their respective surgical procedures. Results No patient in either group experienced accidental vascular injury or hemorrhage. In the improved group, two procedures were unsuccessful due to inadvertent peritoneal puncture and entry into the abdominal cavity, and these peritoneal defects were repaired using transvaginal natural orifice transluminal endoscopic surgery (vNOTES). No other intraoperative or postoperative complications were observed. There were no statistically significant differences between the two groups regarding operative time, length of hospital stay, or estimated blood loss. Both groups showed significant postoperative improvements in POP-Q, PFDI-20, and PFIQ-7 scores. Conclusion Based on these preliminary results, this modified procedure appears to be feasible, safe, and effective for gynecologists experienced in vNOTES and pelvic organ prolapse surgery. However, its efficacy and safety require further validation through larger prospective studies with longer follow-up periods.