Vaginal vault reconstruction.

This report describes a new surgical technic for vaginal vault reconstruction performed on 116 patients either at the time of vaginal hysterectomy or in cases of post-hysterectomy vault suspension for vault prolapse. The repair maintains and restores proper vaginal vault support, preserves or increases overall vaginal length and preserves the proper angle of the vaginal canal. High extraperitoneal plication of the uterosacral ligaments is used to prevent enterocele, and provides hammock-like support of the vaginal vault. The paracervical fascia of the vaginal cuff is closed transversely in the midline rather than anterior-posteriorly.