TY - JOUR
T1 - Single port robotic assisted sacrocolpopexy
T2 - Our experience with the first 25 cases
AU - Matanes, Emad
AU - Lauterbach, Roy
AU - Mustafa-Mikhail, Susana
AU - Amit, Amnon
AU - Wiener, Zeev
AU - Lowenstein, Lior
N1 - Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Objectives: In single-port surgery, the surgeon operates almost exclusively through a single entry point, typically the patient's navel, leaving only a single small scar. The aims of this study were to share some tips and tricks of singleport robotic-assisted sacrocolpopexy and to evaluate the learning curve of mastering the skills to operate this procedure. Methods: This is a retrospective study of the first 25 single-port; roboticassisted sacrocolpopexy surgeries performed during July to December 2015 at Rambam Health Care Campus by a single surgeon. Primary points of interest included intraoperative bleeding, length of surgery, length of hospitalization, and surgical complications. Results: The median age was 59 years (range, 35-74); the median "pelvic organ prolapse quantification" stage was 3 (range, 2-4). The median total operative time was 190 minutes (range, 114-308), and console time was 130 minutes (85-261). Comparisons between the first 15 cases and the following 10 cases demonstrated significant decreases in median total operative and console times: 226 minutes (range, 142-308) versus 156 minutes (range, 114-180), and 170 minutes (range, 85-261) versus 115 minutes (range, 90-270), respectively (P < 0.008). There were no intraoperative adverse events. Postoperative adverse events were also rare, including 1 case of small bowel adhesions that required a second laparoscopic surgery for adhesiolysis. After this incident, we peritonalized the mesh in all 13 successive cases; median time was 8 minutes (range, 5-15 minutes). Conclusions: Single-port robotic-assisted sacrocolpopexy is a feasible procedure with low complication rates, minimal blood loss and postsurgical pain, fast recovery, short hospitalization, and virtually scar-free results. Outcomes of long-term follow-up should be investigated.
AB - Objectives: In single-port surgery, the surgeon operates almost exclusively through a single entry point, typically the patient's navel, leaving only a single small scar. The aims of this study were to share some tips and tricks of singleport robotic-assisted sacrocolpopexy and to evaluate the learning curve of mastering the skills to operate this procedure. Methods: This is a retrospective study of the first 25 single-port; roboticassisted sacrocolpopexy surgeries performed during July to December 2015 at Rambam Health Care Campus by a single surgeon. Primary points of interest included intraoperative bleeding, length of surgery, length of hospitalization, and surgical complications. Results: The median age was 59 years (range, 35-74); the median "pelvic organ prolapse quantification" stage was 3 (range, 2-4). The median total operative time was 190 minutes (range, 114-308), and console time was 130 minutes (85-261). Comparisons between the first 15 cases and the following 10 cases demonstrated significant decreases in median total operative and console times: 226 minutes (range, 142-308) versus 156 minutes (range, 114-180), and 170 minutes (range, 85-261) versus 115 minutes (range, 90-270), respectively (P < 0.008). There were no intraoperative adverse events. Postoperative adverse events were also rare, including 1 case of small bowel adhesions that required a second laparoscopic surgery for adhesiolysis. After this incident, we peritonalized the mesh in all 13 successive cases; median time was 8 minutes (range, 5-15 minutes). Conclusions: Single-port robotic-assisted sacrocolpopexy is a feasible procedure with low complication rates, minimal blood loss and postsurgical pain, fast recovery, short hospitalization, and virtually scar-free results. Outcomes of long-term follow-up should be investigated.
KW - Laparoscopy
KW - Minimal invasive
KW - Robotic surgery
KW - Sacrocolpopexy
KW - Single port
UR - http://www.scopus.com/inward/record.url?scp=85021706878&partnerID=8YFLogxK
U2 - 10.1097/SPV.0000000000000397
DO - 10.1097/SPV.0000000000000397
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C2 - 28134702
AN - SCOPUS:85021706878
SN - 2151-8378
VL - 23
SP - e14-e18
JO - Female Pelvic Medicine and Reconstructive Surgery
JF - Female Pelvic Medicine and Reconstructive Surgery
IS - 3
ER -