Pelvic floor reconstruction: state-of-the-art and beyond

Surgical management of pelvic-organ prolapse has evolved as its pathophysiology and anatomy have been defined better. Traditional approaches to reconstruction include open abdominal and vaginal routes. Techniques and principles from these procedures recently have been applied to laparoscopic repairs. Patient demand and the quest for minimally invasive techniques have popularized the laparoscopic approach. Telerobotic assistance may allow surgeons without advanced laparoscopic skills to perform these operations more simply. The optimal approach to pelvic reconstruction is founded on evidence-based outcomes and individual patient expectations.