Sacrocolpopexy: Conventional Laparoscopic Versus Robot-Assisted Approach

  • Andrea MinerviniEmail author
  • Giampaolo Siena
  • Riccardo Campi
  • Christian Wagner
  • Gianni Vittori
  • Filippo Annino
  • Richard Gaston
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)


Pelvic organ prolapse (POP) is a condition in which the pelvic organs (uterus, bladder and bowel) protrude into or past the vaginal introitus. POP is common and is seen on examination in 40–60% of parous women [1, 2]. Between 6 and 20% of women will have undergone a surgical correction for POP by the age of 80 [3].


  1. 1.
    Handa VL, Garrett E, Hendrix S, et al. Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstet Gynecol. 2004;190(1):27–32.CrossRefGoogle Scholar
  2. 2.
    Hendrix SL, Clark A, Nygaard I, et al. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160–6.CrossRefGoogle Scholar
  3. 3.
    Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116(5):1096–100.CrossRefGoogle Scholar
  4. 4.
    Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;30(4):CD004014.Google Scholar
  5. 5.
    Boyles SH, Weber AM, Meyn L. Procedures for pelvic organ prolapse in the United States, 1979-1997. Am J Obstet Gynecol. 2003;188(1):108–15.CrossRefGoogle Scholar
  6. 6.
    Shah AD, Kohli N, Rajan SS, Hoyte L. The age distribution, rates, and types of surgery for pelvic organ prolapse in the USA. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(3):421–8.CrossRefGoogle Scholar
  7. 7.
    Gerten KA, Markland AD, Lloyd LK, Richter HE. Prolapse and incontinence surgery in older women. J Urol. 2008;179(6):2111–8.CrossRefGoogle Scholar
  8. 8.
    Serati M, Bogani G, Sorice P, et al. Robot-assisted sacrocolpopexy for pelvic organ prolapse: a systematic review and meta-analysis of comparative studies. Eur Urol. 2014;66(2):303–18.CrossRefGoogle Scholar
  9. 9.
    Pan K, Zhang Y, Wang Y, et al. A systematic review and meta-analysis of conventional laparoscopic sacrocolpopexy versus robot-assisted laparoscopic sacrocolpopexy. Int J Gynaecol Obstet. 2016;132(3):284–91.CrossRefGoogle Scholar
  10. 10.
    Ploumidis A, Spinoit AF, De Naeyer G, et al. Robot-assisted sacrocolpopexy for pelvic organ prolapse: surgical technique and outcomes at a single high-volume institution. Eur Urol. 2014;65(1):138–45.CrossRefGoogle Scholar
  11. 11.
    Merseburger AS, Herrmann TR, Shariat SF, et al. EAU guidelines on robotic and single-site surgery in urology. Eur Urol. 2013;64(2):277–91.CrossRefGoogle Scholar
  12. 12.
    Costantini E, Brubaker L, Cervigni M, et al. Sacrocolpopexy for pelvic organ prolapse: evidence-based review and recommendations. Eur J Obstet Gynecol Reprod Biol. 2016;205:60–5.CrossRefGoogle Scholar
  13. 13.
    Lee RK, Mottrie A, Payne CK, Waltregny D. A review of the current status of laparoscopic and robot-assisted sacrocolpopexy for pelvic organ prolapse. Eur Urol. 2014;65(6):1128–37.CrossRefGoogle Scholar
  14. 14.
    Clifton MM, Pizarro-Berdichevsky J, Goldman HB. Robotic female pelvic floor reconstruction: a review. Urology. 2016;91:33–40.CrossRefGoogle Scholar
  15. 15.
    Lane F. Repair of posthysterectomy vaginal-vault prolapse. Obstet Gynecol. 1962;20:72–7.CrossRefGoogle Scholar
  16. 16.
    Maher C, Feiner B, Baessler K, et al. Surgery for women with apical vaginal prolapse. Cochrane Database Syst Rev. 2016; (10).Google Scholar
  17. 17.
    Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol. 1996;175(6):1418–21.CrossRefGoogle Scholar
  18. 18.
    Maher CF, Qatawneh A, Dwyer P, et al. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse. A prospective randomized trial. Am J Obstet Gynecol. 2004;190:20–6.CrossRefGoogle Scholar
  19. 19.
    Lo TS, Wang AC. Abdominal colposacropexy and sacrospinous ligament suspension for severe uterovaginal prolapse: a comparison. J Gynecol Surg. 1998;14:59–64.CrossRefGoogle Scholar
  20. 20.
    Rondini C, Braun H, Alvarez J, et al. High uterosacral vault suspension vs sacrocolpopexy for treating apical defects: a randomized controlled trial with twelve months follow-up. Int Urogynecol J. 2015;26(8):1131–8.CrossRefGoogle Scholar
  21. 21.
    Maher C, Feiner B, DeCuyper E, et al. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011;204(4):360 e1–7.CrossRefGoogle Scholar
  22. 22.
    Abrams P, Cardozo L, Wagg A, Wein A. Incontinence. 6th edition 2017. 6th International Consultation on Incontinence. Tokyo: ICS-ICUD; 2016. ISBN: 978-0-9569607-3-3.Google Scholar
  23. 23.
    Siddiqui NY, Grimes CL, Casiano ER, et al. Mesh sacrocolpopexy compared with native tissue vaginal repair: a systematic review and meta-analysis. Obstet Gynecol. 2015;125(1):44–55.CrossRefGoogle Scholar
  24. 24.
    Brubaker L, Nygaard I, Richter HE, et al. Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence. Obstet Gynecol. 2008;112:49–55.CrossRefGoogle Scholar
  25. 25.
    Nygaard IE, McCreery R, Brubaker L, et al. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol. 2004;104(4):805–23.CrossRefGoogle Scholar
  26. 26.
    Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309(19):2016–24.CrossRefGoogle Scholar
  27. 27.
    Whitehead WE, Bradley CS, Brown MB, et al. Gastrointestinal complications following abdominal sacrocolpopexy for advanced pelvic organ prolapse. Am J Obstet Gynecol. 2007;197:78 e1–7.CrossRefGoogle Scholar
  28. 28.
    Freeman R, Pantazis K, Thomson A, et al. A randomised controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Int Urogynecol J. 2013;24:377–84.CrossRefGoogle Scholar
  29. 29.
    Tyson MD, Wolter CE. A comparison of 30-day surgical outcomes for minimally invasive and open sacrocolpopexy. Neurourol Urodyn. 2015;34(2):151–5.CrossRefGoogle Scholar
  30. 30.
    Higgs PJ, Chua HL, Smith AR. Long term review of laparoscopic sacrocolpopexy. BJOG. 2005;112(8):1134–8.CrossRefGoogle Scholar
  31. 31.
    Rivoire C, Botchorishvili R, Canis M, et al. Complete laparoscopic treatment of genital prolapse with meshes including vaginal promontofixation and anterior repair: a series of 138 patients. J Minim Invasive Gynecol. 2007;14(6):712–8.CrossRefGoogle Scholar
  32. 32.
    Sarlos D, Brandner S, Kots L, et al. Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome—a prospective study with 101 cases. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(10):1415–22.CrossRefGoogle Scholar
  33. 33.
    Paraiso M, Jelovsek J, Frick A, Chen C, Barber M. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol. 2011;118(5):1005–13.CrossRefGoogle Scholar
  34. 34.
    Sergent F, Resch B, Loisel C, Bisson V, Schaal JP, Marpeau L. Mid-term outcome of laparoscopic sacrocolpopexy with anterior and posterior polyester mesh for treatment of genito-urinary prolapse. Eur J Obstet Gynecol Reprod Biol. 2011;156:217–22.CrossRefGoogle Scholar
  35. 35.
    Claerhout F, Roovers JP, Lewi P, et al. Implementation of laparoscopic sacrocolpopexy—a single centre’s experience. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1119–25.CrossRefGoogle Scholar
  36. 36.
    Di Marco DS, Chow GK, Gettman MT, Elliott DS. Robotic-assisted laparoscopic sacrocolpopexy for treatment of vaginal vault prolapse. Urology. 2004;63(2):373–6.CrossRefGoogle Scholar
  37. 37.
    Geller EJ, Lin FC, Matthews CA. Analysis of robotic performance times to improve operative efficiency. J Minim Invasive Gynecol. 2013;20(1):43–8.CrossRefGoogle Scholar
  38. 38.
    Anger J, Mueller E, Tarnay C, Smith B, Stroupe K, Rosenman A, et al. Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2014;123(1):5–12.CrossRefGoogle Scholar
  39. 39.
    Mueller MG, Jacobs KM, Mueller ER, et al. Outcomes in 450 women after minimally invasive abdominal sacrocolpopexy for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2016;22(4):267–71.CrossRefGoogle Scholar
  40. 40.
    Unger CA, Walters MD, Ridgeway B, et al. Incidence of adverse events after uterosacral colpopexy for uterovaginal and posthysterectomy vault prolapse. Am J Obstet Gynecol. 2015;212(5):603.e1–7.CrossRefGoogle Scholar
  41. 41.
    De Gouveia De Sa M, Claydon LS, Whitlow B, Dolcet Artahona MA. Robotic versus laparoscopic sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J. 2016;27(3):355–66.Google Scholar
  42. 42.
    Gutman R, Maher C. Uterine-preserving prolapse surgery. Int Urogynecol J. 2013;24(11):1803–13.CrossRefGoogle Scholar
  43. 43.
    De Gouveia De Sa M, Claydon LS, Whitlow B, Dolcet Artahona MA. Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J. 2016;27(1):3–17.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Andrea Minervini
    • 1
    Email author
  • Giampaolo Siena
    • 1
  • Riccardo Campi
    • 1
  • Christian Wagner
    • 2
  • Gianni Vittori
    • 1
  • Filippo Annino
    • 3
  • Richard Gaston
    • 2
  1. 1.Department of UrologyUniversity of Florence, Careggi HospitalFlorenceItaly
  2. 2.Department of UrologyClinique Saint AugustinBordeauxFrance
  3. 3.Department of UrologySan Donato Hospital Arezzo—Usl Toscana SudEstArezzoItaly

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