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Laparoscopic vs Robotic-assisted Sacrocolpopexy

Table 2: Comparison between laparoscopic and robotic sacrocolpopexy 26
Laparoscopic (n = 47) Robotic (n = 20) p-value
Total operating time (min) 199 ± 47 265 ± 50 <0.001
Operative time (min) 231 ± 69 128 ± 48 <0.001
Mean blood loss (ml) 280 55 0.03
Mean duration of catheter (days) 3.1 ± 1.6 2.5 ± 1.8 0.03
Sacrocolpopexy time (min) 162 ± 47 227 ± 47 <0.001
Hospital stay (h) 34 ± 11 43 ± 37 0.17
Mean cost ($) *$14,342 ± 2,941 $16,278 ± 3,326 0.008
Operating room cost ($) Mean difference: +$1,667 — 0.008
Postop complications (Clavien classification)
Grade I 10 4 0.3
Grade II 5 1 0.3
Grade IIIA — — —
Grade IIIB 3 1 0.7

Table 3: Comparing both techniques in terms of 5. Culligan PJ, Murphy M, Blackwell L, Hammons G, Graham
general principles C, Heit MH. Long-term success of abdominal sacral colpopexy
using synthetic mesh. Am J Obstet Gynecol 2002;187:
Robotic surgery Laparoscopic surgery
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Three-dimensional vision Two-dimensional vision 6. Ramm O, Kenton K. Robotics for pelvic reconstruction. Curr
Motion scaling Not possible Bladder Dysfunct Rep 2011 Jun 30;6(3):176-81.
Wrist articulation Limited range of movement 7. Akladios CY, Dautun D, Saussine C, Baldauf JJ, Mathelin C,
Fluid movement Rigid movement
Tremor filter Tremor is magnified Wattiez A. Laparoscopic sacrocolpopexy for female genital
Remote sensing technology Abdominal wall is the fulcrum organ prolapse: Establishment of a learning curve. Eur J Obstet
Ergonomically intuitive Comparatively poor ergonomics Gynecol Reproductive Biol 2010;149:218-21.
Multiple instrument Not possible 8. Antiphon P, Elard S, Benyoussef A, Fofana M, Yiou R,
ejection system Gettman M, et al. Laparoscopic promontory sacral colpopexy:
Haptic feedback Limited tactile feedback Is the posterior, rectovaginal, mesh mandatory? Eur Urol
Telesurgery and Not possible 2004;45:655-61.
teleproctoring
Small learning curve Long curve 9. Claerhout F, De Ridder D, Roovers JP, Rommens H, Spelzini F,
25 times magnification 10 times magnification Vandenbroucke V, et al. Medium-term anatomic and functional
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Expensive Comparatively costs less curve. Eur Urol 2009;55:1459-68.
10. Cosson M, Rajabally R, Bogaert E, Querleu D, Crepin G.
Laparoscopic sacrocolpopexy, hysterectomy and Burch
CONCLUSION colposuspension: Feasibility and short-term complications
It can be said that laparoscopic as well as robotic-assisted of 77 procedures. J Soc Laparoendoscopic Surg 2002;6:
115-19.
sacrocolpopexy are close to each other in efficacy and robot 11. Gadonneix P, Ercoli A, Salet-Lizee D, Cotelle O, Bolner B,
can offer more comfort with ergonomics. ln the recent years Van Den Akker M, et al. Laparoscopic sacrocolpopexy with
lot of work is going on in the field of robotics. Robotic two separate meshes along the anterior and posterior vaginal
technique has certain definite advantages and is not just a walls for multicompartment pelvic organ prolapse. J Am Assoc
Gynecol Laparosc 2004;11:29-35.
fancy. Being a new technology and that too heavily machine 12. Granese R, Candiani M, Perino A, Romano F, Cucinella G.
dependent, the costs are understandable. As with all Laparoscopic sacrocolpopexyin the treatment of vaginal vault
technical aspects, higher availability and future work may prolapse: Eight years experience. Eur J Obstet Gynecol Repro-
bring down the costs. ductive Biol 2009;146:227-31.
13. Klauschie JL, Suozzi BA, O’Brien MM, McBride AA.
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