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Emily Kluck, Joanna McCann, Sarah Pankow and Drew Theuerkauf ACF Abstract FY13

"Robotic-Assisted Sacrocolpopexy: A Retrospective Review of 211 Cases"

American Urogynecologic Society (AUGS) 33rd Annual Scientific Meeting

Objectives: Robotic-Assisted Sacrocolpopexy (RSC) is gaining popularity as an alternative to open abdominal sacrocolpopexy. The purpose of this study was to evaluate intraoperative and postoperative complications of RSC performed by a single operator.

Materials and Methods: This was a retrospective study involving a review of 211 patients who underwent RSC between October 2007 and February 2012 in a community hospital.

Results: Two hundred and eleven patients underwent RSC for advanced pelvic organ prolapse stage 3 (135 patients) and stage 4 (76 patients). Patients had a mean age of 63.79 (range 39-83) years and mean BMI of 27.60 (SD 3.99). One hundred forty-eight (77%) had previous abdominal surgery. Two hundred six patients (98%) were treated concomitantly with the following procedures: supracervical hysterectomy in 97 (46%), total hysterectomy in one (0.5%), bilateral, right or left oophorectomy in 127 (60%), and lysis of adhesions in 142 (68%). There were three patients (1.5%) who were converted to an open abdominal procedure; two had extensive adhesions and one had a difficult pre-sacral space. Intra-operative complications included one patient (0.5%) who had a cystotomy and was converted to open abdominal. There were no ureter, rectal, small bowel, or major vessel injuries and no blood transfusions. Cystoscopy was routinely performed. Postoperative complications occurred in five patients (2.3%) which included the following: one mesh erosion, one patient developed subcutaneous emphysema, one patient developed post-operative mesh infection, one patient with back pain (discitis), and one patient readmitted with ileus herniated small bowel. Mean operative time was 157.69 (SD 32) minutes and mean length of stay was 24 (SD 4.58) hours.

Conclusions: RSC is a newly evolved procedure for pelvic organ prolapse repair. It is a

feasible and safe procedure with minimal intraoperative and postoperative complication rates when performed by a single surgeon.