Abstract
Objective The aim is to investigate the efficiency and outcome of robotic-assisted sacrocolpopexy (RASC) in a cohort of patients with pelvic organ prolapse (POP) in our Gynecology Department. Methods We performed a retrospective study of female patients who underwent RASC in Chinese PLA General Hospital from January 2013 to December 2020. Their clinical features included age, degree of prolapse, menopause time, body mass index, pregnancy, delivery, operation time, and bleeding volume. All patients were followed up for more than 6 months. POP-Q was recorded to evaluate the position of prolapsed organs. PFDI-20, PFIQ-7, and PGI-I were used to evaluate the life quality after surgery. Results Twenty-four patients with POP received RASC in our center. The intraoperative bleeding was 86.9 ± 98.3 ml (20–300 ml). The operation time was 143.5 ± 47.3 min (60–240 minutes). The hospitalization time was 10.4 ± 2.1 days (8–16 days). And the follow-up time was 40.8 ± 22.0 months (6–72 months). In the POP-Q follow-up, postoperative Aa, Ba, Ap, Bp, and C were significantly improved than those before surgery (P < 0.05). The objective and subjective cure rate was 100%. PGI-I score was very good in 9 (9/24), very good in 10 (10/24), and good in 3 (3/24). Postoperative PFDI-20 and PFIQ-7 were 2.78 ± 3.82 and 1.57 ± 3.86, which decreased dramatically after surgery (P < 0.05). Mesh exposure occurred in 4 cases (16.7%) at 2–12 months. The exposed diameters were less than 1 cm in 3 cases (2 A/T3/S1) and 1-2 cm in 1 case (3 B/T3/S1). These mesh exposures healed after conservative observation or mesh excision. Conclusion RASC for POP has the advantage of less bleeding and hospitalization time. It is a minimally invasive option for pelvic organ prolapse.
Highlights
Pelvic organ prolapse (POP) is a common disease which occurs in about 40–60% of parous women [1, 2]
In our follow-up, a significant improvement in prolapse quantification (POP-Q) score and QOL was found in all patients with an overall objective cure rate of 100%. ese results indicated that it is a minimal invasive technique for POP
Elliott reported the first series of robot-assisted laparoscopic sacrocolpopexy for high-grade vaginal vault prolapse [8]. e first robot-assisted gynecological operation in China was completed in our hospital in 2009
Summary
Pelvic organ prolapse (POP) is a common disease which occurs in about 40–60% of parous women [1, 2]. It causes a variety of symptoms and decreased the life quality of old women [3]. Traditional vaginal surgery for POP has been plagued with high failure rates and complications after mesh-transplantation. Sacrocolpopexy has been the gold standard for the treatment of vaginal vault prolapse for decades [5]. It offers better postoperative results than vaginal surgical techniques [6]
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