Stepwises Technique in Robotic Assisted Notes Sacrocolpopexy

Abstract

<h3>Study Objective</h3> To demonstrate stepwise techniques for the successful utilization of the single-site technique for safely performing transvaginal sacrocolpopexy for pelvic organ prolapse. <h3>Design</h3> Stepwise demonstration with narrated video footage. <h3>Setting</h3> An academic tertiary care hospital. <h3>Patients or Participants</h3> The patient is a 69-year-old G2P2002 with a history of SVD x2 who presented with symptomatic stage II anterior vaginal prolapse (Aa +1) and stage II posterior vaginal prolapse (Ap -1). The preoperative vaginal length was measured at 9 cm. <h3>Interventions</h3> Laparoscopic transvaginal single-site sacrocolpopexy has been demonstrated to be feasible and safe in the surgical management of pelvic organ prolapse. However, retroperitoneal dissection or suturing/knot tying can be technically challenging to perform, especially in the event of an anatomical variation of a deeply angled S1 vertebra. Wristed robotic instrumentation may overcome some of these obstacles and result in easier suturing and knot tying. Integration of a robotic platform for sacrocolpopexy is a novel alternative minimally invasive approach that is more cosmetic, safer and effective. <h3>Measurements and Main Results</h3> The procedure was successfully performed in approximately 227 minutes with a measured postoperative vaginal length of 7 cm. The patient's postoperative pelvic organ prolapse quantification was stage 0. <h3>Conclusion</h3> Robotic-assisted transvaginal single-site sacrocolpopexy for pelvic organ prolapse is feasible, effective, and safe in patients with pelvic organ prolapse.