Robotic Sacrocolpopexy in Pelvic Organ Prolapse

A Review of Current Literature

Dmitry Y. Pushkar; George R. Kasyan; Alexander A. Popov

Disclosures

Curr Opin Urol. 2021;31(6):531-536. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: Recently, robotic sacrocolpopexy has become the gold standard for treating genital prolapse. Despite this, there is still much interest in this procedure, and many questions remain unanswered. This review focuses on the most critical articles on this issue that have been published in the last 2 years.

Recent Findings: A summary of 23 articles is provided. There were no differences in total postoperative complications, postoperative stress incontinence, mesh erosion, and the success of the two surgical techniques in long-term investigations. Obesity modestly increases robotic approach difficulty and does not raise the mesh erosion rate or prolapse recurrence rate. Ultra-light and preprepared meshes with alternative fixation techniques can be applied with these procedures. Another emerging trend is alternative robotic approaches and the use of single-port surgery.

Summary: For women with pelvic organ prolapse, especially the elderly and obese, robotic sacrocolpopexy is well tolerated and effective. Despite highly restricted and heterogeneous data, recent investigations have included single incision methods and new mesh/fixation materials. Randomized trials with large sample size and excellent quality are necessary before the practical implementation of new techniques.

Introduction

Sacrocolpopexy is a common surgical procedure for correction of pelvic organ prolapse (POP). In majority of cases, it is performed by laparoscopy or laparotomy. Currently, laparoscopy is considered the reference procedure as it presents several advantages, such as minimal invasiveness, technical feasibility, operative safety, low morbidity, reduced hospital stay, earlier return to regular activity, and effectiveness in the short and long terms. However, it is poorly ergonomic and requires an extensive learning curve and long operating time for surgeons. To overcome these difficulties, the first robotic-assisted sacrocolpopexy (RSC) was carried out in 2004 by Di Marco.[1] It would seem that comparative analyses of different methods have been repeatedly carried out. But the relevance of such studies remains essential. This also applies to treatment outcomes, long-term results, and long-term complications.

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