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Update on Robotic Versus Laparoscopic Sacrocolpopexy: Outcomes and Costs

  • Minimally Invasive Gynecologic Surgery (A Fader, Section Editor)
  • Published:
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Abstract

The purpose of this review was to critically evaluate literature published over the past three years regarding outcomes and costs of robotic sacrocolpopexy (RSC) versus laparoscopic sacrocolpopexy (LSC). A total of eight studies were selected that directly compared these techniques: two randomized controlled trials, one prospective trial, and five retrospective trials, with follow-ups ranging from three months to three years. RSC and LSC resulted in similar objective and subjective success rates, quality of life outcomes and overall perioperative complication rates. RSC required similar or longer operative times, caused similar or less blood loss and resulted in more short-term postoperative pain. RSC was also associated with higher costs compared to LSC, but this difference was minimal when excluding the robot purchase cost from calculations. Although complication rates were not significantly different in a majority of the studies, the largest retrospective study demonstrated that RSC resulted in a significant increase in the risk of venous thromboembolism and of a conversion to an open procedure. The ultimate choice of route and method of sacrocolpopexy should be individualized, taking into account the surgeon’s experience and the patient's history and characteristics. In conclusion, RSC is an acceptable alternative to LSC for the management of apical vaginal prolapse, but longer follow-up is needed with studies specifically powered to detect differences in costs and outcomes.

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Acknowledgements

The authors would like to thank Twinkle Parekh, a visiting medical student from the All India Institute of Medical Sciences in New Delhi, India, for her contributions.

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Conflict of Interest

Dr. Jennifer L. Hallock, Dr. Jocelyn Fitzgerald and Dr. Chi Chiung Grace Chen each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Division of Female Pelvic Medicine and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Gynecology and Obstetrics, Baltimore, MD, USA

    Jennifer L. Hallock, Jocelyn Fitzgerald & Chi Chiung Grace Chen

  2. Johns Hopkins Bayview Medical Center, 301 Building, Room 3107, 4940 Eastern Ave, Baltimore, MD, 21224, USA

    Chi Chiung Grace Chen

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  1. Jennifer L. Hallock
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Correspondence to Chi Chiung Grace Chen.

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Hallock, J.L., Fitzgerald, J. & Chen, C.C.G. Update on Robotic Versus Laparoscopic Sacrocolpopexy: Outcomes and Costs. Curr Obstet Gynecol Rep 3, 252–264 (2014). https://doi.org/10.1007/s13669-014-0099-2

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