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Robotic Surgery for Pelvic Organ Prolapse

Robot-assisted sacrocolpopexy is performed in order to correct prolapse (falling of vagina, uterus, bladder, or rectum). In this procedure, which is sometimes done with a hysterectomy, mesh is used to anchor the vagina to the sacral cone (a large triangular bone located in the upper back if the pelvis), thereby lifting the vagina into its normal anatomic position.

Sacrocolpopexy is one of the most successful operations used to correct vaginal vault prolapse, and it is considered by many to be the “gold-standard”. It helps to maintain natural vaginal depth and length. Robotic surgery offers a minimally invasive approach, and because robotic sacrocolpopexy avoids the need for a large abdominal incision, women undergoing this procedure are able to experience a less painful recovery with a significantly quicker return to normal activities than would be possible with open surgery.

How is Robotic Sacrocolpopexy Performed

In this procedure, the patient is placed under general anesthesia and 6 small incisions are made in the upper abdomen. In cases of uterine prolapse, a hysterectomy will also be performed with or without preservation of the cervix. It involves attaching one end of a synthetic mesh to the vagina and the other end to the sacral promontory (upper part of the tail bone or lower part of the spine). Finally, tissues are sewn over the mesh to form a barrier between the mesh and surrounding pelvic organs so that the mesh is covered.

Advantages of Robotic Sacrocolpopexy

  • Reduced recovery time and hospital time
  • Less post-operative pain
  • Maintain natural vaginal length and depth

Risks

  • Mesh erosion
  • Chronic pelvic pain
  • Pain with intercourse
  • Failure (recurrence rate <10%)
  • Risks of having surgery itself, including but not limited to bleeding, infection, damage to surrounding structures including bowel and bladder, blood clot, and death