Minimally invasive surgery in urogynecology: a comparison of standard laparoscopic, minilaparoscopic, percutaneous surgical system, and robotic sacral colpopexy

Panico, Giovanni; Campagna, Giuseppe; Vacca, Lorenzo; Caramazza, Daniela; Iannone, Vito; Rossitto, Cristiano; Rumolo, Valerio; Scambia, Giovanni; Ercoli, Alfredo

doi:10.23736/s0026-4806.20.06561-1

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…Patient positioning, pre and post operatory prophylaxis and the procedure were carried out using a standardised technique, as already published by our group ( Campagna et al, 2018 ; Panico et al, 2021 ). The surgical steps are shown in detail in the attached video.…”

Section: Resultsmentioning

confidence: 99%

HUGO(TM) RAS System in urogynaecology: the first nerve sparing Sacral Colpopexy for Pelvic Organ Prolapse

Panico¹,

Campagna²,

Caramazza³

et al. 2023

Facts Views Vis ObGyn

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Background: Minimally invasive sacral colpopexy is considered the gold standard for surgical treatment of Pelvic Organ Prolapse (POP), combining high success rates with low recurrence risk in comparison to other techniques. This is the first case of robotic sacral colpopexy (RSCP) performed with the innovative Hugo™ RAS robotic system. Objectives: The aim of this article is to show the surgical steps of a nerve sparing RSCP performed with the new Hugo™ RAS robotic system (Medtronic), by also evaluating the feasibility of this technique using this novel Robotic System. Materials and methods: A 50-year-old Caucasian woman with symptomatic pelvic organ prolapse (POP-Q): Aa: +2, Ba: +3, C: +4, D: +4, Bp: -2, Ap: -2 , TVL:10 GH: 3,5 BP:3 underwent RSCP as well as a subtotal hysterectomy with bilateral salpingo-oophorectomy, using the new surgical robot Hugo™ RAS in the Division of Urogynaecology and Pelvic Reconstructive Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Main outcome measures: Intraoperative data, docking specifics, objective and subjective outcomes at three months follow up. Results: Surgical procedure was carried out without intra-operative complications, operative time (OT) was 150 minutes, docking time was 9 minutes. No system errors or faults in the robotic arms were registered. Urogynaecological examination at three months follow up showed a complete resolution of the prolapse. Conclusion: RSCP using the Hugo™ RAS system seems to be a feasible and effective approach according to results in terms of operative time, cosmetic results, postoperative pain and length of hospitalisation. Large number of case reports as well as longer follow up are mandatory to better define its benefits, advantages, and costs.

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Section: Resultsmentioning

confidence: 99%

HUGO(TM) RAS System in urogynaecology: the first nerve sparing Sacral Colpopexy for Pelvic Organ Prolapse

Panico¹,

Campagna²,

Caramazza³

et al. 2023

Facts Views Vis ObGyn

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“…In a comprehensive study involving nearly 10,000 patients undergoing various apical suspension techniques with a follow-up extending up to 14.8 years, sacrocolpopexy emerged as the most durable reconstructive solution for prolapse repairs 8 . Laparoscopic sacral colpopexy has overtaken ASC to become the contemporary criterion standard for POP treatment, exhibiting a success rate estimated between 85% and 95% 9,10 . Furthermore, a limited-sample study highlighted the safety, feasibility, and efficacy of LSC in addressing recurrent POP subsequent to prior transvaginal polypropylene mesh surgery 11 …”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Zhao,

Liu,

Cui

et al. 2024

UROGC

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Importance As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension. Objective The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse. Methods This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups. Results In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence. Conclusions In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.

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“…The laparoscopic hysterectomy was at the center of the minimally invasive revolution of gynecologic surgery. Once this technique had been mastered, other, more complex surgeries followed: oncologic hysterectomy, laparoscopic lymphonodectomy, laparoscopic management of severe endometriosis, laparoscopic pelvic floor repair, and—finally—radical laparoscopic hysterectomy [ 5 , 12 , 13 , 14 ].…”

Section: Data Before 2018mentioning

confidence: 99%

“…Minimally invasive surgeries have fundamentally changed abdominal surgery in all aspects. The advantages concerning intra- and perioperative morbidity have consistently been demonstrated [ 4 , 5 , 6 ]. In 2018 a publication put into question the available scientific evidence up to that point [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

New Insights on the Minimal-Invasive Therapy of Cervical Cancer

Gasimli

Wilhelm

Becker

et al. 2022

JCM

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Objective: The ideal management of early-stage cervical cancer has become the subject of a global controversy following the publication of a prospective study in 2018 that reported a worse oncologic outcome when comparing the minimally invasive approach to the laparotomy approach. The discussion involves both prospective and retrospective data and general and theoretical considerations. We wanted to look at the data available today and review the different opinions, offering an impartial assessment of the ongoing controversy. Methods: The available literature was reviewed, focusing on articles arguing for and against minimally invasive surgery in cervical cancer. We tried to avoid any fundamental bias, as is often evident in the available reviews on the subject. Literature both before and after the 2018 publication was taken into consideration. Results: As is usual in discussions of concepts, the literature that is now available provides arguments for both sides of this challenging issue, depending on one’s standpoint. Science-related writing is not immune to trends. There is a curious shift in opinion seen before and after 2018. One must question whether there was a prejudice in favor of minimally invasive surgery prior to the publication of the NEJM articles and a bias against it afterward. Conclusion: Whether further minimally invasive surgery for cervical cancer is invariable is tied to the more pressing question of how this surgery will have to be centralized in the future. Unless these questions are linked, no satisfactory solution can be found.

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Minimally invasive surgery in urogynecology: a comparison of standard laparoscopic, minilaparoscopic, percutaneous surgical system, and robotic sacral colpopexy

Cited by 8 publications

References 26 publications

HUGO(TM) RAS System in urogynaecology: the first nerve sparing Sacral Colpopexy for Pelvic Organ Prolapse

HUGO(TM) RAS System in urogynaecology: the first nerve sparing Sacral Colpopexy for Pelvic Organ Prolapse

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

New Insights on the Minimal-Invasive Therapy of Cervical Cancer

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