Throughout the last few decades, pelvic laparoscopy has progressed from a generic diagnostic tool to a complex armamentarium such as single-port laparoscopy with potential benefits such as decreased postoperative pain, fewer wound complications, and better cosmesis and possible disadvantages of increased cost and operating time. This advancement was partially driven by patients’ demands and expectations with the cosmetic outcome, encouraging the medical industry to innovate on further revolutionary machinery and methods of surgery. However, due to the relatively complex ergonomics, limitations of current laparoscopic instruments, and intricacy of the surgical technique for pelvic floor repair, the uptake of surgeons has been limited.

 The objective of this presentation is to provide a review of current literature in regards to single-port laparoscopic pelvic floor surgery and its feasibility, safety, complication and outcome in comparison to other surgical techniques. The use ofsingle-port surgical technique for prolapse surgeries is limited to few expert surgeon case reports, thus the best available data pertinent to current clinical practice will be presented.

Although laparoscopic single-port surgery has spread across surgical disciplines, this has not been the case for the repair of uterovaginal prolapse. We will show a video-demonstration from 2008 of mesh sacro-hysteropexy conducted, possibly for the first time in the world, to correct apical prolapse classified as stage II POPQ system.

 According to the literature, the single-port laparoscopy seems feasible and safe, with better cosmetic results. The cost is increased and there is no benefit in terms of pain, operating time and duration of hospitalization. Beyond cosmetic results, further randomized studies are needed to determine whether the single-portsurgical technique provides any benefit over conventional or robotic-assisted laparoscopic approaches amongst Endo-gynaecologists with the interest in Uro-gyanaecology. The future of pelvic floor surgery will be single-port robotic-assisted surgery (with reusable arms and equipment), which offers all the advantages of laparoscopic surgery, overcoming the issues related to complexity discussed previously in a cost-effective manner.