Round Ligament Pulley—A Novel Technique of Sling Surgery

Abstract

Background: Uterovaginal (UV) prolapse is a common gynecological disorder often
affecting women in their reproductive years. While traditional surgical treatments
such as vaginal hysterectomy and Manchester repair are effective, they are not
suitable for women wishing to preserve their fertility. This article introduces a novel,
conservative surgical technique—Round Ligament Pulley Sling Surgery—aimed at
treating UV prolapse while preserving reproductive potential.
Methods: This case series was conducted over a period of 10 years (2004–2024) and
involved 200 women with Stage II or III uterovaginal prolapse. The surgical
technique utilized the patient's own round ligament as a supportive sling to reposition
the uterus. Patients were selected based on their desire for fertility preservation and
absence of cervical elongation. Outcomes assessed included procedural success,
complications, future fertility, and delivery outcomes.
Results: All procedures were successful, with no intra- or post-operative
complications. Minimal blood loss and a short operative time were noted. During
one-year follow-up, 56 women conceived, and 49 delivered vaginally. No adverse
reproductive or functional outcomes were reported.
Conclusion: The Round Ligament Pulley technique is a safe, simple, and effective
fertility-preserving surgical option for uterovaginal prolapse. It demonstrates
excellent clinical outcomes and allows for vaginal delivery post-surgery.