Robotic-assisted Laparoscopic Sacrocolpopexy

Robotic-assisted Laparoscopic Sacrocolpopexy: A Feasibility Study

Robotic-assisted Abdominal Sacrocolpopexy is both a feasible and safe method for apical prolapse repair of the vagina.

Robotics offers many advantages over traditional laparoscopy: 1) intuitive movement of instruments, 2) "wristed instruments" with increased degrees of freedom, 3) enhanced 12X magnification, 4) 3-D depth perception, 5)tremor filtration, 6) enhanced surgeon comfort and ergonomics, and 7) a steeper learning curve. With robotic assistance, the surgeon can comfortably perform precise, repetitive motions, with greater dexterity and vision. To date, there have been a small number of published cases of laparoscopic sacrocolpopexy and two cases of series utilizing robotic-assistance. There have been no prospective, randomized, controlled trials comparing either of these modalities to conventional abdominal sacrocolpopexy.

Inclusion Criteria:

• Non-pregnant women
• Age >18 years
• Eligible for sacrocolpopexy
• Prior hysterectomy
• Stage II or greater post hysterectomy vault prolapse
• Satisfied parity
• Patients electing for an abdominal repair to posthysterectomy vault prolapse

Exclusion Criteria:

• Prisoners
• Cognitively impaired adults
• Not medically stable to undergo laparoscopic or abdominal surgery
• Previous pelvic/vaginal radiation
• Participants electing to proceed with a vaginal repair of vaginal vault prolapse
• Participants electing to proceed with the traditional abdominal sacrocolpopexy
• History of recurrent vaginal infections
• Known urologic and/or gynecologic cancer