Journal of Robotic Surgery

, Volume 11, Issue 2, pp 171–177 | Cite as

Robotic and laparoendoscopic single-site utero-sacral ligament suspension for apical vaginal prolapse: evaluation of our technique and perioperative outcomes

  • Hugo H DavilaEmail author
  • Taryn Gallo
  • Lindsey Bruce
  • Christopher Landrey
Original Article


The objective of this study was to evaluate our technique and steps of robotic and laparoendoscopic single-site utero-sacral ligament suspension in the treatment of patients with symptomatic apical vaginal prolapse. A retrospective analysis was done using the data in 2 community hospital. Eighteen women presented with vaginal apex prolapse and desired minimally invasive surgery (video): (a) Laparoendoscopic single-site utero-sacral ligament suspension (LESS-UTSLS) (n = 13) or (b) robotic-assisted single-site utero-sacral ligament suspension (RASS-UTSLS) (n = 5) were eligible to participate. All participants underwent a standardized evaluation, including a structured urogynecologic history and physical examination with pelvic organ prolapse quantitative stage. Participants also completed validated questionnaire about pain scale. Multiples perioperative values were obtained to evaluate our minimally invasive approach. There were no differences in demographic, pre-operative anatomic, and functional data between groups. Concomitant anti-incontinence surgery with trans-obturator tape among the LESS-UTSLS vs RASS-UTSLS groups was performed in 2 (15 %) compared with 0 (0 %) and vaginal hysterectomy 2 (15 %) compared with supracervical hysterectomy 2 (40 %), respectively. The UTSLS operating time was similar in the RASS group compared with the LESS group (difference 9 min. There were only one POP (8 %) recurrence (stage 3) and one umbilical hernia (8 %) in the LESS-UTSLS group after 12 months of surgery. Two patients (15 %) developed stress urinary incontinence after LESS-UTSLS. We presented our technique and perioperative outcomes. RASS-UTSLS was similar operative times to LESS UTSL (+9 min), no differences in post-operative pain, anatomic support, or complications 6 months. We found that robotic surgical systems may accelerate the learning curve in the single-site surgery. Future investigations are warranted to discern the best applications for robotic single site technology in benign gynecologic surgery.


Apical prolapsed Vaginal prolapsed Single-site surgery Robotic surgery Pelvic floor 


Compliance with ethical standards



Conflict of interest

Hugo H. Davila, Taryn Gallo, Lindsey Bruce, and Christopher Landrey declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (MP4 343893 kb)


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Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  • Hugo H Davila
    • 1
    • 2
    • 3
    • 4
    Email author
  • Taryn Gallo
    • 3
  • Lindsey Bruce
    • 3
  • Christopher Landrey
    • 5
  1. 1.Florida Healthcare Specialist, Urology and Minimally Invasive SurgeryFlorida Cancer Specialist & Research InstituteVero BeachUSA
  2. 2.Florida Cancer Specialist & Research InstituteSebastianUSA
  3. 3.Department of Surgery, Division of Urology and GynecologySebastian River Medical CenterSebastianUSA
  4. 4.Florida State University College of MedicineTallahasseeUSA
  5. 5.Department of Surgery, Division of Gynecology and ObstetricsSt. Joseph Health SystemMichiganUSA

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