Surgical management of apical pelvic support defects: the impact of robotic technology

Int Urogynecol J. 2012 Sep;23(9):1183-6. doi: 10.1007/s00192-012-1749-4. Epub 2012 Apr 12.

Abstract

Introduction and hypothesis: Our aim was to determine what effect access to robotic technology had on our approach to managing apical pelvic support defects.

Methods: This was a retrospective chart review of 187 pelvic floor reconstructive surgeries performed for the 18 months prior to (time period 1: January 2007 to July 2008) and following (time period 2: July 2009 to December 2009) the introduction of the robot. Chi-square was used to compare percentages, and analysis of variance (ANOVA) was used to compare demographic data among groups.

Results: Overall, 187 procedures were performed for apical prolapse during the study period: 61 in time period 1 and 126 in time period 2. Following the introduction of robotic technology, a significant change from vaginal to abdominal reconstruction occurred. Uterosacral ligament suspension declined from 67 % to 22 % (p < 0.0001), whereas sacrocolpopexy increased from 25 % (15/61) to 66 % (83/126) (p < 0.0001). The rate of abdominal sacrocolpopexy, however, declined from 25 % (15/61) to 2 % (2/126) over the two time periods (p < 0.0001).

Conclusion: The introduction of robotic technology significantly affected the surgical procedure and mode of surgical access for repair of apical pelvic support defects.

MeSH terms

  • Abdomen / surgery
  • Adnexa Uteri / surgery
  • Adult
  • Aged
  • Analysis of Variance
  • Chi-Square Distribution
  • Female
  • Gynecologic Surgical Procedures / trends*
  • Humans
  • Ligaments / surgery
  • Middle Aged
  • Minimally Invasive Surgical Procedures / trends*
  • Pelvic Organ Prolapse / surgery*
  • Retrospective Studies
  • Robotics / trends*
  • Vagina / surgery