Robotic-Assisted Sacrocolpopexy: A Retrospective Review

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Hager-Lubbers Exhibition Hall

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OBJECTIVES: Robotic-Assisted Sacrocolpopexy (RSC) is gaining popularity as an alternative to open abdominal sacrocolpopexy. The purpose of this study was to evaluate intra-operative and post-operative 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 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 (77.1%) of 192 patients (data missing on 19 subjects) 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 (60.2%), and lysis of adhesions in 143 (74.5%, data missing on 19 subjects). 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. Post-operative complications occurred in five patients (2.3%) and 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 intra-operative and post-operative complication rates when performed by a single surgeon.

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Apr 16th, 3:30 PM

Robotic-Assisted Sacrocolpopexy: A Retrospective Review

Hager-Lubbers Exhibition Hall

OBJECTIVES: Robotic-Assisted Sacrocolpopexy (RSC) is gaining popularity as an alternative to open abdominal sacrocolpopexy. The purpose of this study was to evaluate intra-operative and post-operative 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 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 (77.1%) of 192 patients (data missing on 19 subjects) 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 (60.2%), and lysis of adhesions in 143 (74.5%, data missing on 19 subjects). 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. Post-operative complications occurred in five patients (2.3%) and 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 intra-operative and post-operative complication rates when performed by a single surgeon.