Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse: A Systematic Review and Meta-analysis of Comparative Studies

Serati, Maurizio; Bogani, Giorgio; Sorice, Paola; Braga, Andrea; Torella, Annalaura; Salvatore, Stefano; Uccella, Stefano; Cromi, Antonella; Ghezzi, Fabio

doi:10.1016/j.eururo.2014.02.053

Cited by 156 publications

(121 citation statements)

References 39 publications

(190 reference statements)

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“…Moreover, neither of these reviews compared minimally invasive sacropexy (MISC) and open sacropexy (OSC). The third systematic review [10] focused on robotic sacropexy (RSC) and did not include (among other studies) a recently published randomized controlled trial (RCT) comparing RSC and laparoscopic sacropexy (LSC). Additionally, this third review also included uncontrolled studies which are more susceptible to bias [11].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis

Claydon

Whitlow

et al. 2015

Int Urogynecol J

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Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis

Claydon

Whitlow

et al. 2015

Int Urogynecol J

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“…In a recent meta-analysis examining the results of 27 studies, Serati et al (10) reported that the rates of conversion to open surgery, intraoperative complication and mesh erosion were <1%, 3% and 2%, respectively. Objective cure rates ranged from 84% to 100%.…”

Section: Discussionmentioning

confidence: 99%

Robotic Surgery for the Treatment of Apical Pelvic Organ Prolapse at a Single Institution

Toptaş

Uysal

2017

Gynecol Obstet Reprod Med

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OBJECTIVE:We sought to present implementation of robotic surgery for the treatment of apical pelvic organ prolapse at our clinic, with short-term outcomes.STUDY DESIGN: Clinical data of 11 consecutive patients with apical pelvic organ prolapse, who underwent robotic sacrocolpopexy or hysteropexy between July 2015 and August 2016, were collected prospectively. Primary endpoint of the study was anatomic cure and the secondary endpoint was symptomatic cure. Anatomic cure was defined as lack of anterior or posterior prolapse beyond the hymen and apical prolapse beyond the midvagina. Symptomatic cure was lack of vaginal bulge sensation. RESULTS:Of the 11 patients, 9 underwent sacrocolpopexy and two underwent hysteropexy. Sacrocolpopexy was performed concomitantly with hysterectomy in 7 of the 9 patients. Mean operating time for all procedures was 254±65 minutes. No conversion to open surgery was required and no intraoperative complication was observed in any of the patients. The median hospital stay was 3 days. Four complications occurred postoperatively: 1 case of pulmonary thromboembolism, 2 cases of vaginal vault cellulitis and 1 case of mesh erosion. In total, 10 of 11 patients (90.9%) met the criteria for anatomic and symptomatic cure. CONCLUSION:Robotic pelvic support procedures can be readily adopted to routine clinical practice with high anatomic and symptomatic cure rates.

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“…An additional concern about ASC, open or minimally invasive, is that has been associated with mesh erosion 2% -7% [7] [8]. Development of new surgical techniques that provide good long term support, minimal complications and avoid mesh utilization (Trifecta) is key to permit broader dissemination of minimally invasive abdominal procedures for advanced apical POP.…”

Section: Introductionmentioning

confidence: 99%

“…Laparoscopic sacrocolpopexy has been adopted by many pelvic surgeons as a way to minimize surgical morbidity and quicken patient recovery [3] [4] [5]. Abdominal sacrocolpopexy (ASC) has been shown to have one of the highest long-term anatomic success rates (78% -100%) among procedures for pelvic organ prolapse repair [6] with minimal complications [7]. During ASC identification of the pre-sacral ligament can be difficult, particularly in obese patients.…”

Section: Introductionmentioning

confidence: 99%

Robotic Assisted Laparoscopic Apical Suspension. Description of a 4 Points Technique (RALAS-4): First Case Reported

Davila¹,

Bruce²,

Goodman³

et al. 2017

OJOG

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The uterosacral ligaments (UTSL), together with the cardinal ligament (CL), hold the upper vagina and cervix over the levator plate. These 2 ligaments provided 4 points support at the apex. Here we describe our surgical technique of robotic assisted laparoscopic apical suspension (RALAS) using nonabsorbable sutures and describe a new 4 points technique (RALAS-4). 73-year-old Caucasian woman, gravida 5, para 4 had symptomatic pelvic organ prolapse (POP) apical/anterior stage III. At pelvic ultrasound evaluation the uterus was small and normal appearing of adnexa bilaterally. She failed pessaries and was sexually active. The most relevant complaints were vaginal bulging, pressure and urinary incontinence, mainly stress urinary incontinence; she is using 5 -7 pads/day. Robotic assisted laparoscopic hysterectomy, mid-urthral sling and apical suspension was successfully performed in 125 min. Once we finished with hysterectomy, we proceed with RALAS-4, we used V-Loc 3-0, CV-23 (Covidien) sutures (absorbable) on the right and left uterosacral ligaments (2 points) and theses were reinforced with Gore-Tex 2-0, CV-2 (non-absorbable, Gore Medical). On the right/left anterior apical support we used Gore-Tex 2-0 and these provided the 2 point suspension (UTLS = 2 and anterior vagina = 2). The 2 anterior apical support sutures are taken from the vagina to the transversalis fascia and the obliterated umbilical artery on the anterior abdominal wall. The tension of these anterior sutures was maintained with Hem-o-lock (TeleFlex) and LAPRA-TY (Ethicon). In our opinion RALAS-4 may represents an alternative to robotic or laparoscopic sacrocolpopexy. This new approach simulate the natural 4 points support given by uterosacral ligaments and cardinal ligament, with the additional benefit of

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Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse: A Systematic Review and Meta-analysis of Comparative Studies

Cited by 156 publications

References 39 publications

Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis

Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis

Robotic Surgery for the Treatment of Apical Pelvic Organ Prolapse at a Single Institution

Robotic Assisted Laparoscopic Apical Suspension. Description of a 4 Points Technique (RALAS-4): First Case Reported

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