Long-term outcomes after robotic sacrocolpopexy in pelvic organ prolapse: prospective analysis |
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Authors: | Moreno Sierra Jesús Ortiz Oshiro Elena Fernandez Pérez Cristina Galante Romo Isabel Corral Rosillo Javier Prieto Nogal Sara Castillon Vela Ignacio T Silmi Moyano Angel Alvarez Fernandez-Represa J |
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Affiliation: | Department of Urology, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain. dr_jmoreno@hotmail.com |
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Abstract: | Objective: To evaluate the feasibility and long-term outcomes of our initial series of robot-assisted laparoscopic sacrocolpopexy. Methods: We conducted a prospective analysis of our series of robotic sacrocolpopexy. Inclusion criteria: patients with grades III and IV cystocele and or other symptomatic pelvic organ prolapse. We performed a transperitoneal four-trocar technique with the Da Vinci robotic system using two polypropylene meshes for fixation to the sacral promontory. The primary outcome was recurrence; secondary outcomes included operating room time, blood loss, conversion to open surgery, complications and length of stay. Results: 31 consecutive procedures were included. Mean patient age was 65.2 (50-81) years. Mean operating room time was 186 (150-230) min. We converted 1 case to laparoscopy (3.2%). There were two major complications (1 acute myocardial infarction and 1 reoperation for excess tension with syncopes), two minor complications (1 wound infection and 1 ileus) and no recurrences at a mean follow-up of 24.5 (16-33) months. Conclusions: Robotic sacrocolpopexy could possibly improve with experience after overcoming the learning curve. There is no doubt it is a reproducible technique, but its safety and efficacy still need to be proven. Our initial series demonstrated good outcomes and no recurrences at 24.5 months of follow-up. |
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