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Robotic mesh-supported pectopexy for pelvic organ prolapse: expanding the options of pelvic floor repair

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Abstract

Pelvic organ prolapse affects 30–50% of the female population. For definitive treatment surgery is unavoidable. Sacrocolpopexy has been the gold standard for anatomical correction of pelvic organ prolapse since the 1990s. Recently, pectopexy has been introduced as a new surgical procedure to correct apical prolapse. We have translated the laparoscopic pectopexy into a robotic procedure. The charts of the first 30 consecutive patients who underwent robotic pectopexy at the department for robotic and pelvic floor surgery were reviewed. All patients were analyzed for estimated blood loss, operation time, as well as complications. Treatment success was evaluated after 3–6 months using a composite endpoint including anatomical and subjective components. Of the 30 patients analyzed, 18 underwent hysteropectopexy (n = 18), 6 patients underwent vaginopectopexy and 6 patients underwent cervicopectopexy. Additional procedures were performed in 14 patients, and this influenced operation time and intraoperative blood loss. No intraoperative complications were noted and no conversions were necessary. Treatment success according to the primary composite endpoint was achieved in 30 (100%) patients. Furthermore, neither de novo urgency nor obstructive bowel symptoms were noted in any of the patients treated with robotic pectopexy. Similar to SCP, pectopexy is designed for prolapse repair. The robotic technique for pectopexy capitalizes on the advantages of robotic surgery as compared to conventional laparoscopy since it allows for anatomical preparation and simplification of applying sutures and mesh material, reducing operating time and minimizing surgical trauma. The technique is safe, and anatomical outcomes are excellent.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Paracelsus Medical University, University Women’s Hospital, Klinikum Nuernberg, Nuremberg, Germany

    Dimitrios Bolovis & Cosima Brucker

  2. Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Salzburg, Austria

    Wolfgang Hitzl

  3. Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria

    Wolfgang Hitzl

  4. Department of Research and Innovation, Paracelsus Medical University, Salzburg, Austria

    Wolfgang Hitzl

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  1. Dimitrios Bolovis
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  2. Wolfgang Hitzl
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  3. Cosima Brucker
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Correspondence to Dimitrios Bolovis.

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Authors D. Bolovis, W. Hitzl and C. Brucker declare that they have no relevant financial or non-financial interests to disclose.

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Bolovis, D., Hitzl, W. & Brucker, C. Robotic mesh-supported pectopexy for pelvic organ prolapse: expanding the options of pelvic floor repair. J Robotic Surg 16, 815–823 (2022). https://doi.org/10.1007/s11701-021-01303-7

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  • DOI: https://doi.org/10.1007/s11701-021-01303-7

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