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Technical features, perioperative and anatomical outcomes of a standardized suturing pattern for robotic sacrocolpopexy

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Abstract

Introduction and hypothesis

Several technical alternatives to repair mesh using laparoscopic sacrocolpopexy exist. We aim to describe the outcomes and surgical technique of robotic-assisted colpo-/cervicosacropexy using a standardized suturing scheme to repair the mesh.

Methods

We retrospectively reported data of 60 consecutive cases of robotic-assisted colpo-/cervicosacropexy for advanced multicompartmental prolapse using a standardized suturing design. We placed three non-absorbable stitches on the cervix or three absorbable stitches on the apex of the vaginal vault, six long-term absorbable stitches on the anterior vaginal wall deep to the basis of the vesical trigone, six similar posterior stitches with the deeper row of sutures down to the levator ani plane and three non-absorbable stitches on the sacral promontory as the cranial support for Y-shaped polypropylene mesh.

Results

Median operative time was 188 ± 43 min. All the procedures were successfully performed using a Da Vinci Si platform in a three-arm configuration, and no conversion to open or traditional laparoscopic surgery was needed. The length of hospital stay was 1.2 ± 1.7 days, and no readmission within 30 postoperative days was reported. At a follow-up of 12 and 24 months, no case of extrusion or exposure of the mesh occurred, and the retreatment rate was 6.7%.

Conclusions

Our suturing technique is safe and effective, with negligible risk of complications and good medium-term results. It is plausible that robotic systems may facilitate precise, accurate and reproducible placement of the stitches, thereby favoring wider diffusion of minimally invasive treatment of advanced prolapse.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126, Pisa, Italy

    Andrea Giannini, Eleonora Russo, Giulia Misasi, Maria Falcone, Marta Caretto, Riccardo Morganti, Paolo Mannella & Tommaso Simoncini

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  1. Andrea Giannini
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  2. Eleonora Russo
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  3. Giulia Misasi
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  4. Maria Falcone
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  5. Marta Caretto
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  6. Riccardo Morganti
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  7. Paolo Mannella
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  8. Tommaso Simoncini
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Contributions

A Giannini: Data Collection, Manuscript writing.

E Russo: Project development, Data Collection, Revision of the manuscript.

G Misasi: Project development, Data collection.

M Falcone: Project development, Data collection.

M Caretto: Data collection, Manuscript writing.

R Morganti: Data elaboration, Statistical analysis.

P Mannella: Project development, Surgeon.

T Simoncini: Project development, Surgeon, Supervisor, Revision of the manuscript.

Corresponding author

Correspondence to Andrea Giannini.

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Giannini, A., Russo, E., Misasi, G. et al. Technical features, perioperative and anatomical outcomes of a standardized suturing pattern for robotic sacrocolpopexy. Int Urogynecol J 33, 3085–3092 (2022). https://doi.org/10.1007/s00192-021-05049-6

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  • DOI: https://doi.org/10.1007/s00192-021-05049-6

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