Single Port Robotic Assisted Sacrocolpopexy: Our Experience With the First 25 Cases

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Abstract

Objectives

In single-port surgery, the surgeon operates almost exclusively through a single entry point, typically the patient's navel, leaving only a single small scar. The aims of this study were to share some tips and tricks of single-port robotic-assisted sacrocolpopexy and to evaluate the learning curve of mastering the skills to operate this procedure.

Methods

This is a retrospective study of the first 25 single-port; robotic-assisted sacrocolpopexy surgeries performed during July to December 2015 at Rambam Health Care Campus by a single surgeon.

Methods

Primary points of interest included intraoperative bleeding, length of surgery, length of hospitalization, and surgical complications.

Results

The median age was 59 years (range, 35–74); the median “pelvic organ prolapse quantification” stage was 3 (range, 2–4). The median total operative time was 190 minutes (range, 114–308), and console time was 130 minutes (85–261). Comparisons between the first 15 cases and the following 10 cases demonstrated significant decreases in median total operative and console times: 226 minutes (range, 142–308) versus 156 minutes (range, 114–180), and 170 minutes (range, 85–261) versus 115 minutes (range, 90–270), respectively (P < 0.008). There were no intraoperative adverse events. Postoperative adverse events were also rare, including 1 case of small bowel adhesions that required a second laparoscopic surgery for adhesiolysis. After this incident, we peritonalized the mesh in all 13 successive cases; median time was 8 minutes (range, 5–15 minutes).

Conclusions

Single-port robotic-assisted sacrocolpopexy is a feasible procedure with low complication rates, minimal blood loss and postsurgical pain, fast recovery, short hospitalization, and virtually scar-free results. Outcomes of long-term follow-up should be investigated.

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