Supracervical Robotic-Assisted Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse

Abstract

Supracervical robotic-assisted laparoscopic sacrocolpopexy was found to be an effective repair of apical vaginal defects in patients with pelvic organ prolapse who had not undergone previous hysterectomy.

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

“…Grade 1, 2, and 3 complications were 2 (<1%), 45 (3%), and 1 (<1%), respectively [12]. In particular, Satava grade 2 and 3 complications were 14 vaginotomies (1%), 26 bladder injuries (2%), 1 ureteral injury (<1%), and 4 bowel injuries (<1%) [10,11,16,17,[19][20][21][22][23]28,[31][32][33][34][35][36][38][39][40]. Additionally in one case (<1%), a suture with its needle was lost and a 2-cm incision for needle retrieval was necessary [25].…”

“…Estimated blood losses were of limited entities; no studies reported a mean or median blood loss >150 ml [10,11,. Most studies reported a hospital stay <2 d [16,31,34,35]; three studies reported a median/mean hospitalization time >3 d [18,30,38]. However, the lack of uniformity in reporting operative parameters and the highly variable kinds of concomitant procedures performed (eg, the addition of concomitant hysterectomy) do not allow us to make a fair comparison between groups and evaluate how different surgical volume and different study periods influenced operative results.…”

“…mesh erosion occurred in 31 of 1417 patients (2%) with specific information available [10,11,[16][17][18][19][20][21][22]25,[27][28][29][30][31][32][33][34][35][38][39][40]. Significant heterogeneity in mesh erosion was found among studies ( p < 0.01), thus suggesting difference in sample size, follow-up, and risk factors.…”

“…In agreement with this, the Cochrane review about the surgical management of pelvic organ Data are expressed in number, percentages, median (range or IQR), or mean (standard deviation). [11] Mayo Clinic (AZ)/Mayo Clinic (FL), USA 80 RS 6 (8) [16] Southern Illinois University, Carbondale, IL, USA 33 RS 4 (12) 0 (0) 0 (0) 2 (6) 0 (0) 2 (6) 0 (0) 0 (0) Xylinas et al [17] CHU Henri Mondor, Cré teil, France [18] Chinese University of Hong Kong, China 16 [19] Universidad Complutense, Madrid, Spain [20] Cleveland Clinic (OH), USA 40 [21] University of California/Kaiser Permanente, San Diego, CA, USA…”

“…No grade 4 and 5 complications were recorded. Focusing on severe complications (Clavien-Dindo grade !3a [13]), 20 events (2%) were recorded among 1118 with specific information available [10,11,[16][17][18][19][20][21][22]25,27,28,[30][31][32][33][34][35][37][38][39][40]. Complications included bowel obstructions (n = 5 [25%]), port site hernia (n = 6 [30%]), port site nerve entrapment in a port site (n = 1 [5%]), abscess (n = 3 [15%]), peritonitis due to bowel injury (n = 2 [10%]), vaginal cuff dehiscence (n = 1 [5%]), and feeling of traction requiring secondary surgery (n = 2 [10%]).…”