Miele GM, Marra PM, Cefalì K, et al. - An original technique of a new combined vaginal-laparoscopic lateral suspension in Hysteropexy with cistocele and rectocele was shown. In recent years, interest in uterine-preserving surgery for pelvic organ prolapse has been increasing. In the treatment of apical pelvic organ prolapse, the gold standard is minimally invasive procedures derived from sacrocolpopexy. However, challenges may be faced in dissection at the level of the promontory, particularly in obese women and when an anatomical variation exists. Although rarely, this may lead to serious neurological or ureteral morbidity as well as life-threatening vascular injury. The technique entails 2 times. During the vaginal time, fixation of a polypropylene mesh was done to the cervical fascia and introduction of the 2 extremities in the abdominal cavity was done through the Douglas pouch. During the laparoscopic time, a retroperitoneal tunnel is formed along the walls of the lateral abdominal walls; each of the 2 extremities of the mesh is then passed through the omolateral tunnel and “tension-free” suspended to the abdominal wall. They identified the combined technique as possibly valuable for allowing a safer approach, decreasing the risks of serious complications. In addition, a more physiological orientation of the vaginal axis was attained with using this technique.