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Midterm results of robot-assisted sacrocolpopexy

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Abstract

Introduction and hypothesis

Robotic assistance simplifies laparoscopic procedures. We hypothesize that robot-assisted sacrocolpopexy is a rapid and safe procedure with satisfying short-term and midterm functional results.

Methods

After informed consent, we enrolled 101 consecutive patients undergoing sacrocolpopexy at Alfried Krupp Hospital, Essen, Germany. After a median follow-up of 22 months, we assessed midterm functional results as the primary endpoint. Secondary endpoints included surgical duration, blood loss, intraoperative complications, and postoperative complications. We described frequencies as counts (percent) and continuous data as median [interquartile range (Q1–Q3)] or mean [standard deviation (SD)], as appropriate.

Results

We enrolled 101 patients. The mean age was 69 years (SD 11); 75 women (74.3 %) had undergone previous abdominal surgery. Among the patients, 95 (94.1 %) presented with anterior vaginal wall prolapse Baden-Walker grade 2–3, 74 (73.3 %) vaginal vault prolapse, and 9 (8.9 %) concomitant rectocele. Fifty (50 %) patients underwent a modified Burch procedure in addition to sacrocolpopexy. The median surgical duration was 96 min (Q1–Q3 83–130). There were six (5.9 %) minor intraoperative complications but no conversions to open surgery. Postoperatively, we registered five (4.9 %) Clavien-Dindo grade I complications, three (3.0 %) grade II complications, and one (1.0 %) grade III complication. After a median follow-up of 22 months (Q1–Q3 12–49), the patients reported significant decreased impact of pelvic organ prolapse (POP) on quality of life as well as bother resulting from POP symptoms. The overall success rate, defined as none or minor impact of POP on quality of life, was 75 %.

Conclusions

In this single-surgeon study, robot-assisted sacrocolpopexy was a safe and rapidly performed procedure that achieved good medium-term functional results.

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Conflicts of interest

Stephan Buse acts as proctor for the da Vinci Si-HD® System, Intuitive Surgical, Inc., Sunnyvale, CA, USA. C.E. Hach, J. Krude, A. Reitz, M. Reiter, and A. Haferkamp declare that they have no conflicts of interest.

Authors’ contributions

C.E. Hach: protocol/project development, data collection, data analysis, manuscript writing. J. Krude: data collection. A. Reitz: data analysis, manuscript editing. M. Reiter: data analysis, manuscript editing. A. Haferkamp: data analysis, manuscript editing. S. Buse: protocol/project development, data analysis, manuscript writing.

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Authors and Affiliations

  1. Department of Urology, Alfried Krupp Krankenhaus, Essen, Germany

    Carolin Eva Hach, Joschka Krude & Stephan Buse

  2. KontinenzZentrum Hirslanden, Zurich, Switzerland

    Andre Reitz

  3. Department of Urology, Johann Wolfgang Goethe University, Frankfurt, Germany

    Michael Reiter, Axel Haferkamp & Stephan Buse

Authors
  1. Carolin Eva Hach
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  2. Joschka Krude
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  3. Andre Reitz
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  4. Michael Reiter
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  5. Axel Haferkamp
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  6. Stephan Buse
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Corresponding author

Correspondence to Stephan Buse.

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Hach, C.E., Krude, J., Reitz, A. et al. Midterm results of robot-assisted sacrocolpopexy. Int Urogynecol J 26, 1321–1326 (2015). https://doi.org/10.1007/s00192-015-2688-7

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  • DOI: https://doi.org/10.1007/s00192-015-2688-7

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