2738 Comparing Postoperative Pain with Laparoscopic Versus Robotic Sacrocolpopexy

Abstract

Study Objective To compare postoperative pain and pain-related outcomes following laparoscopic (LS-MISC) versus robotic minimally invasive sacrocolpopexy (R-MISC). Design Secondary analysis of placebo-controlled RCT examining preoperative IV acetaminophen on postoperative pain following MISC. Setting Planned secondary analysis of multicenter RCT. Patients or Participants Women undergoing MISC. Interventions Primary outcome was total narcotics within 24 hours in morphine mg equivalents (MME) comparing LS-MISC and R-MISC. Measurements and Main Results We included 90 subjects undergoing MISC: 65 LS-MISC and 25 R-MISC. Most were Caucasian (97.8%) and postmenopausal (88.9%) with mean age 61.2±7.2 years and BMI 27.6±4.4 kg/m2. IV acetaminophen did not impact pain in the original study and was similar between LS-MISC and R-MISC. Baseline POP-Q stage was similar between groups. Concomitant hysterectomy was performed in 67% with LS-MISC, 60% with R-MISC (p=0.49). LS-MISC underwent more concomitant perineorrhaphies (15.4% vs 0%, p=0.04) and posterior repairs (18.5% vs 0%, p=0.02). Operative time was longer with LS-MISC (208.5±57.3 vs 143.6±21.0 minutes, p= Conclusion L-MISC showed increased length of stay and drowsiness. Most other outcomes showed either no difference or differences disappeared once adjusting for confounders as with primary outcome. Overall, MME narcotic use and VAS pain scales were low as were narcotic medication side effects.