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Surgical management of apical pelvic support defects: the impact of robotic technology

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Abstract

Introduction and hypothesis

Our aim was to determine what effect access to robotic technology had on our approach to managing apical pelvic support defects.

Methods

This was a retrospective chart review of 187 pelvic floor reconstructive surgeries performed for the 18 months prior to (time period 1: January 2007 to July 2008) and following (time period 2: July 2009 to December 2009) the introduction of the robot. Chi-square was used to compare percentages, and analysis of variance (ANOVA) was used to compare demographic data among groups.

Results

Overall, 187 procedures were performed for apical prolapse during the study period: 61 in time period 1 and 126 in time period 2. Following the introduction of robotic technology, a significant change from vaginal to abdominal reconstruction occurred. Uterosacral ligament suspension declined from 67 % to 22 % (p < 0.0001), whereas sacrocolpopexy increased from 25 % (15/61) to 66 % (83/126) (p < 0.0001). The rate of abdominal sacrocolpopexy, however, declined from 25 % (15/61) to 2 % (2/126) over the two time periods (p < 0.0001).

Conclusion

The introduction of robotic technology significantly affected the surgical procedure and mode of surgical access for repair of apical pelvic support defects.

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Conflicts of interest

Dr. Matthews has received honoraria from Intuitive Surgical for symposia and for serving as a robotic surgery case observation site.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System, Richmond, VA, USA

    Ashley W. Carroll, Elizabeth Lamb, Audra Jo Hill & Edward J. Gill

  2. University of North Carolina, Campus Box 7570, Chapel Hill, NC, USA

    Catherine A. Matthews

Authors
  1. Ashley W. Carroll
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  2. Elizabeth Lamb
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  3. Audra Jo Hill
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  4. Edward J. Gill
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  5. Catherine A. Matthews
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Corresponding author

Correspondence to Catherine A. Matthews.

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Carroll, A.W., Lamb, E., Hill, A.J. et al. Surgical management of apical pelvic support defects: the impact of robotic technology. Int Urogynecol J 23, 1183–1186 (2012). https://doi.org/10.1007/s00192-012-1749-4

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  • DOI: https://doi.org/10.1007/s00192-012-1749-4

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