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Comparing the outcomes and effectiveness of robotic-assisted sacrocolpopexy and laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse

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Abstract

Introduction and hypothesis

Abdominal sacrocolpopexy is regarded as the gold standard for management of pelvic organ prolapse (POP). Nowadays, minimally invasive surgeries are preferred, and sacrocolpopexy can be performed using either a laparoscopic or robotic-assisted approach. The aim of the current study was to compare the efficacy and safety of robotic-assisted sacrocolpopexy (RASC) and laparoscopic sacrocolpopexy (LSC) through an updated systematic review and meta-analysis.

Methods

We performed a systematic literature review of different databases and related references from their inception until July 2020 without language restrictions. All randomized control trials and comparative studies that compared RASC and LSC for the management of POP were included.

Results

A total of 13 studies including 2115 participants were included for the pooled analysis. The pooled results revealed that RASC was associated with a significantly longer operative time (weighted mean difference, 29.53 min; 95% confidence interval [CI], 12.88 to 46.18 min, P = 0.0005), significantly less estimated blood loss (weighted mean difference, −86.52 ml; 95% CI −130.26 to −42.79 ml, P = 0.0001), significantly fewer overall intraoperative complications (odds ratio [OR] 0.6; 95% CI 0.40 to 0.91; P = 0.01) and significantly lower conversion rate (OR 0.39; 95% CI 0.19 to 0.82; P = 0.01) compared with LSC. There were no significant differences between the length of hospital stays, overall postoperative complications, postoperative stress incontinence, mesh erosion and effectiveness between the two groups.

Conclusion

The current study showed comparable efficacy between RASC and LSC. Though RASC was associated with less blood loss and a lower conversion rate, the differences were not clinically significant. The choice of surgical procedure with either RASC or LSC is according to surgeon discretion and patient preferences.

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Data availability

All data generated or analyzed during this study are included in this published article.

References

  1. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24(11):1783–90.

    Article  Google Scholar 

  2. Fleischer K, Thiagamoorthy G. Pelvic organ prolapse management. Post Reprod Health. 2020;26(2):79–85.

    Article  CAS  Google Scholar 

  3. Ng-Stollmann N, et al. The international discussion and the new regulations concerning transvaginal mesh implants in pelvic organ prolapse surgery. Int Urogynecol J. 2020;31(10):1997–2002.

    Article  Google Scholar 

  4. Nosti PA, et al. Outcomes of abdominal and minimally invasive sacrocolpopexy: a retrospective cohort study. Female Pelvic Med Reconstr Surg. 2014;20(1):33–7.

    Article  Google Scholar 

  5. De Gouveia De Sa, M., et al. Robotic versus laparoscopic sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J Pelvic Floor Dysfunction. 2016;27(3):355–366.

    Article  Google Scholar 

  6. Pan K, et al. A systematic review and meta-analysis of conventional laparoscopic sacrocolpopexy versus robot-assisted laparoscopic sacrocolpopexy. Int J Gynecol Obstet. 2016;132(3):284–91.

    Article  Google Scholar 

  7. Illiano E, et al. Robot-assisted vs laparoscopic sacrocolpopexy for high-stage pelvic organ prolapse: a prospective, randomized, single-center study. Urology. 2019;134:116–23.

    Article  Google Scholar 

  8. Mueller MG, et al. Outcomes in 450 women after minimally invasive abdominal sacrocolpopexy for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2016;22(4):267–71.

    Article  Google Scholar 

  9. Unger CA, et al. Perioperative adverse events after minimally invasive abdominal sacrocolpopexy. Am J Obstet Gynecol. 2014;211(5):547.e1–8.

    Article  Google Scholar 

  10. Cucinella G, et al. Robotic versus laparoscopic sacrocolpopexy for apical prolapse: a case-control study. Il Giornale di chirurgia. 2016;37(3):113–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Bump RC, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.

    Article  CAS  Google Scholar 

  12. Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

    Article  Google Scholar 

  13. Borenstein M, et al. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. 2010;1(2):97–111.

    Article  Google Scholar 

  14. Paraiso MF, et al. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol. 2011;118(5):1005–13.

    Article  Google Scholar 

  15. Anger JT, et al. Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2014;123(1):5–12.

    Article  Google Scholar 

  16. Seror J, et al. Prospective comparison of short-term functional outcomes obtained after pure laparoscopic and robot-assisted laparoscopic sacrocolpopexy. World J Urol. 2012;30(3):393–8.

    Article  Google Scholar 

  17. Awad N, et al. Implementation of a new procedure: laparoscopic versus robotic sacrocolpopexy. Arch Gynecol Obstet. 2013;287(6):1181–6.

    Article  Google Scholar 

  18. Antosh DD, et al. Short-term outcomes of robotic versus conventional laparoscopic sacral colpopexy. Female Pelvic Med Reconstr Surg. 2012;18(3):158–61.

    Article  Google Scholar 

  19. Pulliam SJ, Weinstein MM, Wakamatsu MM. Minimally invasive apical sacropexy: a retrospective review of laparoscopic and robotic operating room experiences. Female Pelvic Med Reconstr Surg. 2012;18(2):122–6.

    Article  Google Scholar 

  20. Tan-Kim J, et al. Robotic-assisted and laparoscopic sacrocolpopexy: comparing operative times, costs and outcomes. Female Pelvic Med Reconstr Surg. 2011;17(1):44–9.

    Article  Google Scholar 

  21. Chan SSC, et al. Laparoscopic sacrocolpopexy for the treatment of vaginal vault prolapse: with or without robotic assistance. Hong Kong Medical Journal. 2011;17(1):54–60.

    CAS  PubMed  Google Scholar 

  22. Choussein S, et al. Robotic assistance confers ambidexterity to laparoscopic surgeons. J Minim Invasive Gynecol. 2018;25(1):76–83.

    Article  Google Scholar 

  23. Truong M, et al. Advantages of robotics in benign gynecologic surgery. Curr Opin Obstet Gynecol. 2016;28(4):304–10.

    Article  Google Scholar 

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Acknowledgments

The authors would like to thank the team at Taipei Tzu Chi Hospital Library for their support in the database search and the development of this paper.

Funding

The authors did not receive support from any organization for this study.

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Authors and Affiliations

  1. Division of Urology, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei City, 231, Taiwan

    Chia-Lun Chang & Shang-Jen Chang

  2. School of Medicine, Tzu Chi University, Hualien, 970, Taiwan

    Chia-Lun Chang & Shang-Jen Chang

  3. Department of Neurology, Taipei Municipal Wanfang Hospital, Taipei, Taiwan

    Chun-Hua Chen

Authors
  1. Chia-Lun Chang
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  2. Chun-Hua Chen
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  3. Shang-Jen Chang
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Correspondence to Shang-Jen Chang.

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This is a systematic review and meta-analysis study. The Research Ethics Committee has confirmed that no ethical approval is required.

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Appendix

Appendix

Table 1 Study characteristics of included studies
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Table 2 Overall postoperative complications
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Chang, CL., Chen, CH. & Chang, SJ. Comparing the outcomes and effectiveness of robotic-assisted sacrocolpopexy and laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse. Int Urogynecol J 33, 297–308 (2022). https://doi.org/10.1007/s00192-021-04741-x

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  • DOI: https://doi.org/10.1007/s00192-021-04741-x

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