Robotic Sacrocolpopexy Treatment of Vaginal Vault Prolapse in Females

  • Amita Jain

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Abdominal Sacrocolpopexy (ASC) involves the placement of a bridge of graft material to attach the prolapsed vagina to anterior longitudinal ligament of sacrum. Candidates for Abdominal Sacrocolpopexy (ASC) include women with symptomatic stage II or greater prolapse including apical Relaxation. The durability of sacrocolpopexy and its potential benefits for sexual function (preservation of vaginal length and axis and lower rate of dyspareunia) make this procedure a good option for even primary repair in relatively young, sexually active women.

This video gives a comprehensive overview of understanding the concept, selection of patient, preoperative preparation including positioning and placement of ports and detailed operative technique with clear demonstration of surgical anatomy and tips to avoid technical nuances and potential complications; which will be helpful for all those specialists, who are dealing with Female Urology (Urogynecologists, female urologists, minimally invasive pelvic surgeons, reconstructive surgeons, general urologists, general gynecologists, medical students, residents, patients, sonographers, radiologists). In addition, given the high definition picture, magnified image, and limited movement secondary to human manipulation, the robotic approach provides an excellent opportunity to film and educate on the steps and anatomy crucial to this procedure. Same steps can be replicated in open or laparoscopic approach, as per surgeon expertise.

Introduction

This video gives a comprehensive overview of understanding the concept, selection of the patient, along with preoperative preparation.

About The Author

Amita Jain

Dr Amita Jain is a graduate from King George Medical College, Lucknow, India and then she obtained her Masters in Obstetrics & Gynaecology from Sarojini Naidu Medical college, Agra, India in 2003. Thereafter she received training in endoscopic surgeries from BEAMS, Mumbai, India followed by fellowship in Urogynaecology from James Cook University, Queensland, Australia in 2009. At present she is the General Secretary of SAFUG (South Asian Federation of Urogynaecology), Executive Committee Member of GIBS (Global IC and Bladder Pain Syndrome Society) and an active member of IUGA (International Urogynecological Association). Also she served as Chairperson of Urogynaecology Subcomittee AOGD ( Association of Obstetricians & Gynaecologists of Delhi) 2017-2019.

She has received many prestigious awards including International Continence Society Travel Award and Appreciation Award from Association of Obstetricians and Gynaecologists of Delhi for her valuable contribution. Besides this, she has written and published extensively on this upcoming field of Urogynecology and has several publications in peer reviewed national and international journals including book chapters. Recently she was also honoured for being nominated for the post of Southern Asia Representative of International Advisory Board at International Urogynaecological Association.

With a vast experience of regularly performing all named surgeries in urogynaecological field vaginal or abdominal (open/ laparoscopic / robotic), she has pioneered several advanced procedures in her country including dynamic MRI pelvis and 2D/3D transperineal USG as diagnostic modalities and first TVT- Abbrevo placement and robotic burch colposuspension for stress urinary incontinence. She has also organized and has been involved as a faculty in many educational conferences, CMEs & workshops, group activities and patient awareness sessions at both national and international forums and is also a part of many national projects like formation of guidelines, fellowship programmes and research. She also continues to be a reviewer of many prestigious journals like Indian Journal of Urology, International Urogynecology Journal, Proceedings in Obstetrics & Gynecology.

 

About this video

Author(s)
Amita Jain
DOI
https://doi.org/10.1007/978-981-33-4446-4
Online ISBN
978-981-33-4446-4
Total duration
17 min
Publisher
Springer, Singapore
Copyright information
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2020

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Video Transcript

[MUSIC PLAYING]

Robotic sacrocolpopexy– abdominal sacrocolpopexy involves the placement of a bridge of graft material to attach the prolapsed vagina to anterior longitudinal ligament of sacrum. Candidates for abdominal sacrocolpopexy include, women with symptomatic stage-II or greater relapse, including a Apical relaxation. The durability of sacrocolpopexy and its potential benefits for sexual function, like preservation of vaginal length, and access, and lower rate of dyspareunia makes this procedure a good option for even primary repair in relatively young, sexually active women.

While the basics of this tragedy have remained the same, advances have been made in surgical access point and more recently, robotic abdominal sacrocolpopexy has become the preferred corrective procedure for wall prolapse among many patients and providers, as it is minimally invasive, with added advantage of reduced intraoperative blood loss, decreased hospital length of stay, along with a shorter learning curve than laparoscopic technique.

This video will give a comprehensive overview of preoperative preparation, including positioning and placement of ports, detailed operative technique with clear demonstration of surgical anatomy, and tips with technical nuances to avoid potential complications. In addition, given the high-definition picture, magnified image and limited movements again, due to human manipulation, the robotic approach provides an excellent opportunity to fill and educate on the steps and anatomy crucial to this procedure. The same steps can be replicated in open or laparoscopic approach, as per surgeon expertise.