Robotic-Assisted Sacrocolpopexy

Robotic-assisted sacrocolpopexy is a type of surgery done to address pelvic organ prolapse.

The pelvis is a bowl-shaped cavity located in the abdomen, which also houses several other organs, including the uterus, bladder, and the lower part of the intestines. These organs are held in place by strong tissues; but if they weaken, one or more of these organs may drop down and press against or bulge into the vagina and cause a condition called pelvic organ prolapse.

One type of pelvic organ prolapse, called vaginal vault prolapse, is when the upper part of the vagina folds down into the lower part or pushes outside the vaginal opening. This may occur after a hysterectomy.

Robotic-assisted sacrocolpopexy is a minimally invasive procedure done to pull up the tissues and move the organs back into place.

Robotic-assisted sacrocolpopexy can help alleviate the following symptoms of pelvic organ prolapse:

• Fullness or pressure in the vagina
• A bulge in the vagina or tissue bulging out from the vagina
• Accidental urination when coughing, sneezing, or laughing
• Sudden urges to urinate
• Constipation
• Pain during sexual intercourse

Some individuals may be treated with pelvic floor exercises or the use of a pessary, which is a small device inserted into the vagina to provide support. If these treatment options fail to provide relief, or if patients have moderate to severe prolapse, a physician may recommend surgery only if they don’t plan on having children in the future.

The benefits of robotic-assisted sacrocolpopexy, compared to other treatment options, include:

• Lower risk of complications for some people
• Shorter hospital stay
• Faster recovery time

Patients should speak to their physician to determine if this surgery is right for them.

Share the list of medications you take with your provider, including over-the-counter medicines, herbs, vitamins, and other supplements. You may need to stop taking blood thinners a few days before surgery and quit smoking.

The patient will be put under general anesthesia, and the surgeon will begin by placing small tools and a tiny camera through small incisions on the lower abdomen. This will give the surgeon a better view of the treatment area.

Using a robotic controller, the surgeon will move the instruments in extremely precise movements and sew a graft of tissue or synthetic mesh onto the pelvic organs that have prolapsed. The graft will then be attached to a bony area at the lower part of the spinal column to help keep the pelvic organs in their proper position. The surgeon will then remove the tools, close the incisions, and bandage the treatment area.

The risks of a robotic-assisted sacrocolpopexy include:

• Infection
• Excess bleeding
• Blood clots that can travel to the lungs and cause breathing problems
• Injury to nearby organs such as the bowel or ureters
• Wound healing problems
• Pain during sexual intercourse
• Inflammation in the vagina if mesh is used
• Reaction to anesthesia
• Failure of the organs to stay in place
• Return of prolapse symptoms
• Movement of the mesh
• Need for more surgery