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  • Review Article
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Robotic pelvic organ prolapse surgery

Nature Reviews Urology volume 12, pages 216–224 (2015)Cite this article

Subjects

Key Points

  • 10 years of data support the efficacy and safety of robotic sacrocolpopexy (RSC)

  • RSC is associated with less blood loss, pain, and faster recovery time than abdominal sacrocolpopexy (ASC)

  • RSC has a shorter learning curve than LSC

  • Success with RSC depends on meticulous attention at several key surgical points

Abstract

Robotic sacrocolpopexy (RSC) has rapidly gained popularity over the past 10 years, owing to claims that it is associated with a reduced learning curve compared with standard laparoscopic sacrocolpopexy (LSC) and that it has equal efficacy to the gold-standard treatment, abdominal sacrocolpopexy (ASC). The specifics of the surgical technique used for RSC vary widely, but the basic steps and principles are largely the same. Although complication rates are low, specific complications can be minimized by meticulous attention to surgical technique at several important points in the procedure. Multiple levels of evidence support the efficacy of RSC, and show that it is associated with a shorter hospital stay and convalescence than ASC. The learning curve for RSC usually comprises 10–20 procedures but for those with extensive experience of laparoscopy it is likely to be even shorter. RSC is more expensive than LSC but cheaper than ASC. As RSC has only been used for about a decade, we await long-term outcomes of more than a few years.

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Figure 1: The abdominal sacrocolpopexy.
Figure 2: An example of a 'W' port configuration for RSC and important structures to avoid.
Figure 3: Performing a sacrohysteropexy.

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Authors and Affiliations

  1. Department of Urology, Oregon Health & Science University, CH10U, 3303 SW Bond Avenue, Portland, 97239, OR, USA

    Kamran P. Sajadi

  2. Glickman Urological and Kidney Institute, The Cleveland Clinic, Q10-1, 9500 Euclid Avenue, Cleveland, 44195, OH, USA

    Howard B. Goldman

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Both authors made a substantial contribution to discussion of content, wrote the article and reviewed and edited the manuscript before submission. K.P.S. researched data for the article.

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Correspondence to Kamran P. Sajadi.

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Sajadi, K., Goldman, H. Robotic pelvic organ prolapse surgery. Nat Rev Urol 12, 216–224 (2015). https://doi.org/10.1038/nrurol.2015.51

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