Female pelvic organ prolapse is a gynecological disease with a high incidence, mainly manifested as a series of structural and functional abnormalities such as pelvic organ bulge (e.g. uterine prolapse, anterior and posterior vaginal wall bulge, etc.), stress urinary incontinence (i.e. easy urine overflow when coughing or laughing) and chronic pelvic pain. Although it is not a fatal disease, it seriously affects the quality of daily life and the psychological well-being of patients. It is currently believed that birth injury and postmenopausal decrease in estrogen levels are the main causes of its development. Pelvic organ prolapse can be divided into three categories: the first category is bladder and urethral prolapse; the second category is anterior and posterior vaginal wall, vaginal vault (i.e., top of vagina), and uterine prolapse; and the third category, rectal prolapse. Prolapse of one organ can coexist with prolapse of other organs. Their clinical manifestations and degree of prolapse vary and, therefore, there are many different surgical approaches to them. Repairing the prolapse of all these organs belongs to pelvic floor reconstruction surgery, but the mesh used in pelvic floor reconstruction is expensive and has disadvantages such as mesh erosion and susceptibility to infection, which limit its application. With the development of gynecologic laparoscopic technology and the continuous exploration of gynecologists at home and abroad, laparoscopy has been increasingly and skillfully applied in pelvic floor repair surgery. The surgical methods of laparoscopic pelvic floor repair are introduced: 1. Laparoscopic Burch operation Laparoscopic Burch operation is similar to the traditional open Burch operation. Two sutures are placed on each side of the bladder neck and proximal urethra with non-absorbable sutures, and Cooper’s ligament is sutured throughout to elevate the anterior vaginal wall to a position of moderate tension to correct the angle of the bladder neck. Many studies have shown that laparoscopic Burch has the advantages of less intraoperative bleeding, less postoperative pain and faster recovery compared with open Burch; the overall complication rate of open Burch is higher than that of laparoscopic Burth; however, the incidence of bladder injury is higher with laparoscopic Burch than with open Burch. 2. Laparoscopic paravaginal repair is used to repair defects in the lateral vaginal wall. For patients with lateral vaginal wall defects and stress urinary incontinence, the paravaginal defect can be repaired before the Burch procedure. The laparoscopic paravaginal repair is performed similarly to the Burch suspension, using non-absorbable sutures to suture, knot and fix the entire anterior vaginal wall (except the mucosa) to the central tendon located in the lateral pelvic wall. Each side of the vagina usually requires 3 to 5 stitches for repair. When lateral paravaginal repair is performed, the sutures do not pass through the vaginal mucosa and the patient’s sexual function can be significantly improved after surgery. 3.Laparoscopic sacral fixation This procedure has been practiced and reported by many doctors at home and abroad. Its cure rate is 96%, sexual function improvement is 100%, and recurrence rate is 4%. It can be divided into sacral vaginal fixation, sacral cervical fixation and sacral uterine fixation depending on the attachment point of repair. Laparoscopic sacral fixation is a safe and effective surgical procedure for the treatment of pelvic organ prolapse. It reduces intraoperative bleeding and pain compared to the traditional open route, and has the advantages of rapid recovery and short hospital stay. It is currently the most used laparoscopic pelvic floor repair procedure. 4.Laparoscopic shortening of the uterosacral ligament This procedure is performed to lift the prolapsed uterus mainly by strengthening the uterosacral ligament itself, so its indications should be selected for patients without uterosacral ligament dysfunction or weakness, otherwise the surgical result is poor or easy to recur. However, the majority of patients with pelvic organ prolapse have atrophy and thinning of pelvic floor tissues, therefore, this procedure has been used less often in pelvic floor repair alone. 5.Laparoscopic suspension of sacral ligament vaginal vault During the operation, the uterosacral ligament and rectovaginal septum are laparoscopically sutured through and fixed with the vaginal vault. Since the area of this procedure is deep in the pelvis, both open and transvaginal surgery are difficult, whereas laparoscopy allows for clearer identification of anatomical structures and easier manipulation of separation and suturing, reducing damage to organs such as the bladder and rectum. Laparoscopic-assisted transvaginal pelvic floor repair is easier to identify the pelvic anatomy under the magnified view of the laparoscope, thus reducing the complications associated with the procedure; and the combination of the laparoscope, which extends the surgeon’s arm, and the transvaginal approach to repair the defect, makes up for some of the deficiencies of using only one method to repair the pelvic floor organs, allowing some structures that are otherwise inaccessible or difficult to reach to be repaired or strengthened. The combination of the two has made it possible to repair or strengthen structures that would otherwise be inaccessible or difficult to reach. In recent years, gynecologists nationally and internationally have explored a variety of laparoscopic pelvic floor repair procedures. Currently, the results of laparoscopic Burch and sacral fixation are positive, while the clinical value of other procedures still needs to be confirmed by accumulating a certain sample of controlled clinical studies. With the increasing aging of the society, the incidence of pelvic organ prolapse is on the rise, and with the increase in patients’ demand for quality of life, minimally invasive surgery, mainly laparoscopic, will play a pivotal role in the treatment of pelvic organ prolapse.