Abstract
Robot-assisted laparoscopic sacrocolpopexy (RSC) has gained popularity as a method for easier intracorporeal suturing than conventional laparoscopic sacrocolpopexy. However, few studies have compared multiport RSC (MP-RSC) and single-incision RSC (SI-RSC). We aimed to compare perioperative outcomes between these techniques for advanced pelvic organ prolapse (POP). We analyzed 126 patients who underwent RSC for POP quantification (all stage III to IV) between March 2019 and May 2021 at Seoul Asan Medical Center. We prospectively collected operation-related data, including total operation time (OT; from skin incision to closure) and perioperative outcomes. A total of 106 and 20 patients underwent MP-RSC and SI-RSC, respectively. The mean ages were 57.49 ± 10.89 and 56.20 ± 10.30 years in the MP-RSC and SI-RSC groups, respectively. The mean total OT was significantly shorter for MP-RSC than for SI-RSC (105.43 ± 24.03 vs. 121.10 ± 26.28 min). The OT difference was 15.67 min (95% confidence interval, 3.90–25.85, p = 0.009). No statistically significant differences were observed in terms of perioperative variables (estimated blood loss, hospital stay) and postoperative adverse events (POP recurrence, mesh erosion). SI-RSC had comparable intraoperative and postoperative outcomes to MP-RSC, with additional cosmetic benefits. MP-RSC had significantly shorter OT than SI-RSC.
Highlights
Pelvic organ prolapse (POP) is a relatively common condition that is reported to be evident on gynecologic examination in 40% to 60% of parous women [1,2]
Among 288 patients who underwent Robot-assisted laparoscopic sacrocolpopexy (RSC) performed by a single surgeon (S.R.L.)— between January 2015 and February 2019 at Ewha Womans University Mokdong Hospital, as well as between March 2019 and May 2021 at Seoul Asan Medical Center—a total of 126 consecutive patients who underwent RSC between March 2019 and May 2021 at Seoul Asan Medical Center were included in this study to minimize the bias associated with intrapersonal surgical proficiency and institution
multiport RSC (MP-RSC), multiport robot-assisted laparoscopic sacrocolpopexy; single-incision RSC (SI-RSC), single-incision robot-assisted laparoscopic sacrocolpopexy; AEs, adverse events; Hb, hemoglobin; POP, pelvic organ prolapse, a p-value was calculated using an independent t-test, b p-value was calculated using Fisher’s exact test. In this retrospective comparative study of SC, we investigated the feasibility and perioperative outcomes of MP-RSC and SI-RSC
Summary
Pelvic organ prolapse (POP) is a relatively common condition that is reported to be evident on gynecologic examination in 40% to 60% of parous women [1,2]. The importance of POP is increasing in aging societies owing to its high prevalence of 30% among women aged >50 years [3]. The probability that a woman will undergo surgery for POP by 80 years of age is estimated to be 20% [4]. Abdominal sacrocolpopexy (SC) has been recognized as the gold-standard surgical treatment for apical compartment prolapse. In SC, a mesh is attached to the cervix or vagina and suspended to the anterior longitudinal ligament of the sacrum [5,6]. The procedure has been reported to have a higher success rate (78–100%) than vaginal approaches for apical prolapse [5]
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