Robotic Sacrocolpopexy with Autologous Fascia Lata

Abstract

Objectives: Apical prolapse involves the upper vagina or vaginal vault after hysterectomy. Treatment is indicated for symptomatic women, and surgical approach is considered for women who failed or refused conservative therapy. We performed 10 pickups of autologous fascia, used for robotic sacrocolpopexy (RSCP). Materials and Methods: We included patients between 60 and 80 years old who showed a Pelvic Organ Prolapse Quantification (POP-q) over the second stage and with symptoms related to prolapse. Results: All of them underwent autologous fascia lata (AFL) pickup from the right leg and after to RSCP. One patient underwent also posterior colporrhaphy. The mean intraoperative time was 199.2 min (183–230 min). No intra-operatory complications were reported. POP-q assessment during follow-up showed improvements: C point gained on average 7.6 points (5–8) and mean values went from −0.6 to − 8.2 cm (−7 to −9 cm). The three women who had anterior compartment defects shows good anatomical reconstitution with a mean Aa and Ba value of − 2.83 cm (−2.5 to −3 cm) and gained 4 points (average gain: 3.5–4.5 cm). Total vaginal lenght (TVL). Conclusion: According to these data, in our experience, AFL employment showed a good anatomical result from the first to last follow-up.

A comparative analysis of the HUGOTM robot‐assisted surgery system and the Da Vinci® Xi surgical system for robot‐assisted sacrocolpopexy for pelvic organ prolapse treatment

“…In this context, robot-assisted sacrocolpopexy (RASC), originally introduced in 2004, has rapidly emerged as a valid option by combining the advantages of the abdominal approach with those of RAS. [6][7][8][9][10] While a few reports have demonstrated the feasibility and safety of RASC using the novel HUGO™ RAS System, 11,12 no previous studies have compared procedures performed with two different surgical platforms. Therefore, the aim of our study was to compare the outcomes of RASC performed with the Da Vinci ® Xi surgical system and the HUGO™ RAS System.…”

“…Pelvic floor reconstructive surgery has witnessed significant developments, transitioning from the traditional vaginal approach to minimally invasive abdominal surgery, which offers enhanced visualisation and dexterity. In this context, robot‐assisted sacrocolpopexy (RASC), originally introduced in 2004, has rapidly emerged as a valid option by combining the advantages of the abdominal approach with those of RAS 6–10 . While a few reports have demonstrated the feasibility and safety of RASC using the novel HUGO™ RAS System, 11,12 no previous studies have compared procedures performed with two different surgical platforms.…”

Narrative review of flaps and grafts in robotic reconstructive urologic surgery

“…The use of fascia lata can be associated with donor site complications, such as a thigh bulge, paresthesia, or seroma formation ( 74 ). However, this procedure is typically well-tolerated without significant gait deficits or complications ( 74 , 75 , 77 ).…”

Unexpected discovery of fetal bones instead of an intrauterine device: A unique gynecological case report

“…The presence of retained bone fragments within the endometrium poses significant 28 – 31 implications for fertility , often mimicking the function of an IUD by creating a physical barrier to implantation. This can lead to challenges in achieving pregnancy, highlighting the critical nature of complete extraction for those seeking fertility restoration.…”