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Robot-assisted sacrocolpopexy for pelvic organ prolapse: surgical technique and outcomes at a single high-volume institution.
Eur Urol. 2014 Jan; 65(1):138-45.EU

Abstract

BACKGROUND

Pelvic organ prolapse (POP) represents a common female pelvic floor disorder that has a serious impact on quality of life. Several types of procedures with different surgical approaches have been described to correct these defects, but the optimal management is still debated.

OBJECTIVE

To describe our surgical technique of robot-assisted sacrocolpopexy (RASC) for POP and to assess its safety and long-term outcomes.

DESIGN, SETTING, AND PARTICIPANTS

A retrospective review of the medical records of 95 consecutive patients who underwent RASC for POP at our centre from April 2006 to December 2011 was performed.

SURGICAL PROCEDURE

RASC with use of polypropylene meshes was performed in all cases using a standardised technique with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) in a four-arm configuration.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Clinical data were collected in a dedicated database. Intraoperative variables, postoperative complications, and outcomes of RASC were assessed. A descriptive statistical analysis was performed.

RESULTS AND LIMITATIONS

Median operative time was 101 min. No conversion to open surgery was needed. One vaginal and two bladder injuries occurred and were repaired intraoperatively. Only one Clavien grade 3 postoperative complication was observed (bowel obstruction treated laparoscopically). At a median follow-up of 34 mo, persistent POP was observed in four cases (4.2%). One mesh erosion occurred and required robot-assisted removal of the mesh. Ten (10.5%) patients complained de novo urgency after RASC, which resolved in the first few weeks after surgery. No significant de novo bowel or sexual symptoms were reported.

CONCLUSIONS

Our technique of RASC for correction of POP is safe and effective, with limited risk of complications and good long-term results in the treatment of all types of POP. The robotic surgical system facilitates precise and accurate placement of the meshes with short operative time, thereby favouring wider diffusion of minimally invasive treatment of POP.

PATIENT SUMMARY

We studied the treatment of patients with vaginal prolapse by using a robot-assisted surgical technique to fix the vaginal wall with a synthetic mesh. This technique was found to be safe and effective, with limited risk of complications and good long-term results.

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Authors+Show Affiliations

Ploumidis A
OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium.
Spinoit AF
No affiliation info available
De Naeyer G
No affiliation info available
Schatteman P
No affiliation info available
Gan M
No affiliation info available
Ficarra V
No affiliation info available
Volpe A
No affiliation info available
Mottrie A
No affiliation info available

MeSH

AgedFemaleGynecologic Surgical ProceduresHumansMiddle AgedPelvic Organ ProlapsePostoperative ComplicationsRetrospective StudiesRoboticsSacrumUrologic Surgical ProceduresVagina

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23806518

Citation

Ploumidis, Achilles, et al. "Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse: Surgical Technique and Outcomes at a Single High-volume Institution." European Urology, vol. 65, no. 1, 2014, pp. 138-45.
Ploumidis A, Spinoit AF, De Naeyer G, et al. Robot-assisted sacrocolpopexy for pelvic organ prolapse: surgical technique and outcomes at a single high-volume institution. Eur Urol. 2014;65(1):138-45.
Ploumidis, A., Spinoit, A. F., De Naeyer, G., Schatteman, P., Gan, M., Ficarra, V., Volpe, A., & Mottrie, A. (2014). Robot-assisted sacrocolpopexy for pelvic organ prolapse: surgical technique and outcomes at a single high-volume institution. European Urology, 65(1), 138-45. https://doi.org/10.1016/j.eururo.2013.05.054
Ploumidis A, et al. Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse: Surgical Technique and Outcomes at a Single High-volume Institution. Eur Urol. 2014;65(1):138-45. PubMed PMID: 23806518.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robot-assisted sacrocolpopexy for pelvic organ prolapse: surgical technique and outcomes at a single high-volume institution. AU - Ploumidis,Achilles, AU - Spinoit,Anne-Françoise, AU - De Naeyer,Geert, AU - Schatteman,Peter, AU - Gan,Melanie, AU - Ficarra,Vincenzo, AU - Volpe,Alessandro, AU - Mottrie,Alexandre, Y1 - 2013/06/11/ PY - 2013/04/18/received PY - 2013/05/30/accepted PY - 2013/6/29/entrez PY - 2013/6/29/pubmed PY - 2014/7/1/medline KW - Pelvic organ prolapse KW - Robot-assisted surgery KW - Sacrocolpopexy KW - Surgical technique SP - 138 EP - 45 JF - European urology JO - Eur Urol VL - 65 IS - 1 N2 - BACKGROUND: Pelvic organ prolapse (POP) represents a common female pelvic floor disorder that has a serious impact on quality of life. Several types of procedures with different surgical approaches have been described to correct these defects, but the optimal management is still debated. OBJECTIVE: To describe our surgical technique of robot-assisted sacrocolpopexy (RASC) for POP and to assess its safety and long-term outcomes. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of the medical records of 95 consecutive patients who underwent RASC for POP at our centre from April 2006 to December 2011 was performed. SURGICAL PROCEDURE: RASC with use of polypropylene meshes was performed in all cases using a standardised technique with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) in a four-arm configuration. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Clinical data were collected in a dedicated database. Intraoperative variables, postoperative complications, and outcomes of RASC were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: Median operative time was 101 min. No conversion to open surgery was needed. One vaginal and two bladder injuries occurred and were repaired intraoperatively. Only one Clavien grade 3 postoperative complication was observed (bowel obstruction treated laparoscopically). At a median follow-up of 34 mo, persistent POP was observed in four cases (4.2%). One mesh erosion occurred and required robot-assisted removal of the mesh. Ten (10.5%) patients complained de novo urgency after RASC, which resolved in the first few weeks after surgery. No significant de novo bowel or sexual symptoms were reported. CONCLUSIONS: Our technique of RASC for correction of POP is safe and effective, with limited risk of complications and good long-term results in the treatment of all types of POP. The robotic surgical system facilitates precise and accurate placement of the meshes with short operative time, thereby favouring wider diffusion of minimally invasive treatment of POP. PATIENT SUMMARY: We studied the treatment of patients with vaginal prolapse by using a robot-assisted surgical technique to fix the vaginal wall with a synthetic mesh. This technique was found to be safe and effective, with limited risk of complications and good long-term results. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/23806518/Robot_assisted_sacrocolpopexy_for_pelvic_organ_prolapse:_surgical_technique_and_outcomes_at_a_single_high_volume_institution_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(13)00568-X DB - PRIME DP - Unbound Medicine ER -