dr shirodkar invented this surgery for cases of nulliparous prolapse as well for those who had a prolapse after delivery due to poor uterine support and hence required mersilene tape to buttress the uterosacral ligaments.on the left side the psoas muscle loop helps to hitch the tape as the approach to the left uterosacral ligament is prevented by the sigmoid colon.there is no hindrance on the right side.the tape is anchored at the insertion of the uterosacral ligaments anteriorly and the sacral promontory posteriorly
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