Obstet Gynecol Sci.  2024 Mar;67(2):212-217. 10.5468/ogs.23226.

Robotic sacrocolpopexy

• Mozon AO
• Kim JH
• Lee SR

• KMID: 2553428
• DOI: http://doi.org/10.5468/ogs.23226

Abstract

Pelvic organ prolapse (POP) is a common cause of gynecological disease in elderly women. The prevalence of POP has increased with an aging society. Abdominal sacrocolpopexy (ASC) is safer and more effective than the vaginal approach in patients with apical compartment POP because it has a higher anatomical cure rate, a lower recurrence rate, less dyspareunia, and improved sexual function. Laparoscopic sacrocolpopexy (LSC) has replaced ASC. Robotic sacrocolpopexy (RSC) also helps overcome the challenges of LSC by facilitating deep pelvic dissection and multiple intracorporeal suturing. The RSC is technically easy to apply, has a steep learning curve, and offers many advantages over the LSC. However, insufficient data led us to conclude that the LSC is superior overall, especially in terms of costeffectiveness. The present review provides insights into different aspects of RSC, highlighting the most common benefits and concerns of this procedure. We searched for eligible articles discussing this issue from January 2019 to March 2022 to reveal the outcomes of RSC.

Keyword

Pelvic organ prolapse; Robotic surgical procedure; Sacrocolpopexy; Surgical mesh; Minimally invasive surgical procedures

Reference

References

1. Shek KL, Dietz HP. Assessment of pelvic organ prolapse: a review. Ultrasound Obstet Gynecol. 2016; 48:681–92.

2. Nam G, Lee SR, Kim SH, Chae HD. Importance of trans-labial ultrasound for the diagnosis of pelvic organ prolapse and its correlation with the POP-Q examination: analysis of 363 cases. J Clin Med. 2021; 10:4267.

3. Brown JS, Waetjen LE, Subak LL, Thom DH, Van den Eeden S, Vittinghoff E. Pelvic organ prolapse surgery in the United States, 1997. Am J Obstet Gynecol. 2002; 186:712–6.

4. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010; 116:1096–100.

5. Løwenstein E, Ottesen B, Gimbel H. Incidence and lifetime risk of pelvic organ prolapse surgery in Denmark from 1977 to 2009. Int Urogynecol J. 2015; 26:49–55.

6. Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women: 2010 to 2050. Obstet Gynecol. 2009; 114:1278–83.

7. Yuk JS, Lee JH, Hur JY, Shin JH. The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse: a Korean national health insurance database-based cross-sectional study 2009–2015. Sci Rep. 2018; 8:1334.

8. Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V. The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG. 2005; 112:971–6.

9. Nygaard I, Bradley C, Brandt D. Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol. 2004; 104:489–97.

10. Oliphant SS, Jones KA, Wang L, Bunker CH, Lowder JL. Trends over time with commonly performed obstetric and gynecologic inpatient procedures. Obstet Gynecol. 2010; 116:926–31.

11. Oh S, Namkung HR, Yoon HY, Lee SY, Jeon MJ. Factors associated with unsuccessful pessary fitting and reasons for discontinuation in Korean women with pelvic organ prolapse. Obstet Gynecol Sci. 2022; 65:94–9.

12. Park J, Bak S, Song JY, Chung YJ, Yuki G, Lee SJ, et al. Robotic surgery in gynecology: the present and the future. Obstet Gynecol Sci. 2023; 66:518–28.

13. Oh S, Shin JH. Outcomes of robotic sacrocolpopexy. Obstet Gynecol Sci. 2023; 66:509–17.

14. Lethaby A, Mukhopadhyay A, Naik R. Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database Syst Rev. 2012; (4):CD004993.

15. Oh S, Jeon MJ. How and on whom to perform uterine-preserving surgery for uterine prolapse. Obstet Gynecol Sci. 2022; 65:317–24.

16. Dawood AS, Harras HF, Moussa HR, Soliman AS. Surgical outcomes of laparoscopic trachelectomy following supracervical hysterectomy: a multicenter study. Obstet Gynecol Sci. 2022; 65:542–51.

17. van Zanten F, Lenters E, Broeders IA, Schraffordt Koops SE. Robot-assisted sacrocolpopexy: not only for vaginal vault suspension? An observational cohort study. Int Urogynecol J. 2022; 33:377–84.

18. van Zanten F, Schraffordt Koops SE, O’Sullivan OE, Lenters E, Broeders I, O’Reilly BA. Robot-assisted surgery for the management of apical prolapse: a bi-centre prospective cohort study. BJOG. 2019; 126:1065–73.

19. Prendergast E, Silver H, Johnson LL, Simon M, Feinglass J, Kielb S, et al. Anatomic outcomes of robotic assisted supracervical hysterectomy and concurrent sacrocolpopexy at a tertiary care institution at initial adaptation of the procedure. Female Pelvic Med Reconstr Surg. 2016; 22:29–32.

20. Slopnick EA, Roberts K, Sheyn DD, Chapman GC, El-Nashar S, Mahajan ST. Factors influencing selection of concomitant total versus supracervical hysterectomy at the time of sacrocolpopexy and associated perioperative outcomes. Female Pelvic Med Reconstr Surg. 2021; 27:415–20.

21. Nassif J, Yadav GS, Orejuela FJ, Turrentine MA. Rate of mesh erosion after sacrocolpopexy with concurrent supracervical compared with total hysterectomy: a systematic review and meta-analysis. Obstet Gynecol. 2022; 140:412–20.

22. Culligan PJ, Lewis C, Priestley J, Mushonga N. Long-term outcomes of robotic-assisted laparoscopic sacrocolpopexy using lightweight y-mesh. Female Pelvic Med Reconstr Surg. 2020; 26:202–6.

23. Sassani JC, Ross JH, Lopa S, Handzel RM, Bradley MS, Bonidie M. Prolapse recurrence after sacrocolpopexy mesh removal: a retrospective cohort study. Female Pelvic Med Reconstr Surg. 2020; 26:92–6.

24. Giannini A, Russo E, Misasi G, Falcone M, Caretto M, Morganti R, et al. Technical features, perioperative and anatomical outcomes of a standardized suturing pattern for robotic sacrocolpopexy. Int Urogynecol J. 2022; 33:3085–92.

25. Thomas TN, Davidson ERW, Lampert EJ, Paraiso MFR, Ferrando CA. Long-term pelvic organ prolapse recurrence and mesh exposure following sacrocolpopexy. Int Urogynecol J. 2020; 31:1763–70.

26. Chang CL, Chen CH, Chang SJ. Comparing the outcomes and effectiveness of robotic-assisted sacrocolpopexy and laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse. Int Urogynecol J. 2022; 33:297–308.

27. Deblaere S, Hauspy J, Hansen K. Mesh exposure following minimally invasive sacrocolpopexy: a narrative review. Int Urogynecol J. 2022; 33:2713–25.

28. Joint position statement on the management of mesh-related complications for the FPMRS specialist. Female Pelvic Med Reconstr Surg. 2020; 26:219–32.

29. Capmas P, Suarthana E, Larouche M. Conversion rate of laparoscopic or robotic to open sacrocolpopexy: are there associated factors and complications? Int Urogynecol J. 2021; 32:2249–56.

30. Sappenfield EC, Scutari T, O’Sullivan DM, Tulikangas PK. Predictors of delayed postoperative urinary retention after female pelvic reconstructive surgery. Int Urogynecol J. 2021; 32:603–8.

31. Guiahi M, Kenton K, Brubaker L. Sacrocolpopexy without concomitant posterior repair improves posterior compartment defects. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19:1267–70.

32. Chang OH, Davidson ERW, Thomas TN, Paraiso MFR, Ferrando CA. Does concurrent posterior repair for an asymptomatic rectocele reduce the risk of surgical failure in patients undergoing sacrocolpopexy? Int Urogynecol J. 2020; 31:2075–80.

33. Bradley MS, Askew AL, Vaughan MH, Kawasaki A, Visco AG. Robotic-assisted sacrocolpopexy: early postoperative outcomes after surgical reduction of enlarged genital hiatus. Am J Obstet Gynecol. 2018; 218:514e1–8.