Robotic-assisted pelvic organ prolapse surgery

Ayav, Ahmet; Bresler, L.; Hubert, Jacques; Brunaud, Laurent; Boissel, P

doi:10.1007/s00464-004-2257-5

Cited by 99 publications

(64 citation statements)

References 21 publications

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“…The surgical procedure performed to place the anterior mesh in this series was similar to other authors' description [12] . We have chosen Y-shaped polypropylene meshes covered by acellular collagen, in order to make them more biocompatible trying to reduce the risk of mesh extrusion.…”

Section: Discussionmentioning

confidence: 53%

“…We have chosen Y-shaped polypropylene meshes covered by acellular collagen, in order to make them more biocompatible trying to reduce the risk of mesh extrusion. Vaginal mesh extrusion and erosion have been described as postoperative complications by other authors [10,12] . There were no mesh extrusions in this series.…”

Section: Discussionmentioning

confidence: 99%

“…This group published their 2-year outcomes in 2006 [11] . The team of Ayav [12] published in 2005 a series of 18 pelvic prolapses including 12 colpohysteropexies. Daneshgari et al [14] published in 2007 the outcomes of 15 cases.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Outcomes after Robotic Sacrocolpopexy in Pelvic Organ Prolapse: Prospective Analysis

Sierra¹,

Oshiro²,

Pérez

et al. 2011

Urol Int

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Objective: To evaluate the feasibility and long-term outcomes of our initial series of robot-assisted laparoscopic sacrocolpopexy. Methods: We conducted a prospective analysis of our series of robotic sacrocolpopexy. Inclusion criteria: patients with grades III and IV cystocele and or other symptomatic pelvic organ prolapse. We performed a transperitoneal four-trocar technique with the Da Vinci robotic system using two polypropylene meshes for fixation to the sacral promontory. The primary outcome was recurrence; secondary outcomes included operating room time, blood loss, conversion to open surgery, complications and length of stay. Results: 31 consecutive procedures were included. Mean patient age was 65.2 (50–81) years. Mean operating room time was 186 (150–230) min. We converted 1 case to laparoscopy (3.2%). There were two major complications (1 acute myocardial infarction and 1 reoperation for excess tension with syncopes), two minor complications (1 wound infection and 1 ileus) and no recurrences at a mean follow-up of 24.5 (16–33) months. Conclusions: Robotic sacrocolpopexy could possibly improve with experience after overcoming the learning curve. There is no doubt it is a reproducible technique, but its safety and efficacy still need to be proven. Our initial series demonstrated good outcomes and no recurrences at 24.5 months of follow-up.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Long-Term Outcomes after Robotic Sacrocolpopexy in Pelvic Organ Prolapse: Prospective Analysis

Sierra¹,

Oshiro²,

Pérez

et al. 2011

Urol Int

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“…The results of sacrocolpopexy are similar to those obtained by open surgery. The robot is especially useful for better visualization and handling in the presacral region, as well as in the insertion of a mesh and its secure fixation to the vaginal stump, the cervical stump, or the presacral area (15). Re-anastomosis of the fallopian tubes for the purpose of refertilization is associated with a success rate of 67.6% in open surgery, and a 5.6% incidence of ectopic pregnancies.…”

Section: Application In Benign Gynecological Diseasesmentioning

confidence: 99%

Robotic surgery in gynecology

Alkatout

Mettler

Maass

et al. 2016

J Turkish German Gynecol Assoc

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Review 224 Robotic surgery in gynecologyRobotic surgery is a dynamic development for minimally invasive procedures. The specialty of gynecology consistently offers new opportunities for innovative surgical techniques and the advancement of existing therapy approaches (Figure 1). Ever since the American FDA granted approval of the Da Vinci operation robot for gynecological operations in 2005, about three million robotic operations have been performed worldwide. 3500 Da Vinci systems are currently in use: 586 of these in Europe and 77 in Germany (4 th quarter of 2015). According to the figures of Intuitive Surgical, about 600,000 interventions were performed on a worldwide basis in the year 2014, of which 50% were performed in gynecology, approximately 30% in urology, and about 20% in general and chest surgeries. In 2011, the proportion of robotic hysterectomies performed for benign indications in the USA was as high as 27% (1). Currently, we have experience in robotic surgery for the majority of gynecological operations and fields of application. The known advantages of minimally invasive surgery, such as less blood loss, shorter durations of hospital stay, and lower patient morbidity compared to open procedures, have been observed here as well. Better exposure of the operating field by 3D technology and the extension of surgical instruments to 7 degrees of freedom permit the use of minimally invasive surgery, even for complex indications. Robot-assisted manipulation of the instruments permits tremor-free handling and reduces work fatigue for the surgeon, which is very advantageous for the surgeon as well as the patient in long and complex interventions. The possibility of working simultaneously on two parallel consoles shortens the learning curve, reduces complication rates, and facilitates the training of surgeons (2). The advancement of robotic surgery in terms of the Da Vinci Xi permits the variable use of optics in all four trocars (paraaortic lymphadenectomy, omentectomy, or interdisciplinary surgery in the upper abdomen can be performed without re-docking) and ensures markedly greater flexibility due to the optimized geometry of the so-called patient cart. Robotic surgery has been criticized for the fact that it requires the use of larger trocars compared to conventional laparoscopy, and is therefore associated with more numerous and larger cosmetic scars; this is avoided by the smaller trocars now used in robotic surgery (3). The development of the single-site systems signifies further new options for the gynecological surgeon (Figure 2). For instance, freedom of movement is now maximized by the introduction of one or more additional working trocars (4, 5). The low level of postoperative pain appears to be another advantage. It is accompanied by a lesser need for analgesics and even shorter hospital stays compared to traditional laparoscopic surgery. One explanation could be the fact that the abdominal wall need not be used as a counter bearing. The absence of irritation and the advantage of tissue protec...

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“…They concluded that using the da Vinci robotic system is feasible, safe and effective for the treatment of pelvic organ prolapse. 117 Robot-assisted rectovaginopexy was described in 15 women by Draaisma et al 118 Median set-up robot time was 10 minutes, and median skin-to-skin operating time was 160 minutes, median blood loss less than 50 ml and median hospital stay was 4 days. Two other small series of six and ten women also showed the feasibility of this procedure.…”

Section: Pelvic Surgery (Urogynaecology)mentioning

confidence: 99%

Robotic surgery

and

Verheijen

2008

BJOG

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Over the past decade, there has been an exponential growth of robot-assisted procedures and of publications concerning roboticassisted laparoscopic surgery. From a review of the available literature, it becomes apparent that this technology is safe and allows more complex procedures in many fields of surgery, be it at relatively high costs. Although randomised controlled trials in gynaecology are lacking, available evidence suggests that particularly in gynaecology robotic surgery might not only reduce morbidity but also be cost effective if performed in high-volume centres. Training in robotic surgery and programs for safe and effective implementation are necessary.

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Robotic-assisted pelvic organ prolapse surgery

Abstract: Our experience indicates that using the da-Vinci robotic system is feasible, safe, and effective for the treatment of pelvic organ prolapse.

Cited by 99 publications

References 21 publications

Long-Term Outcomes after Robotic Sacrocolpopexy in Pelvic Organ Prolapse: Prospective Analysis

Long-Term Outcomes after Robotic Sacrocolpopexy in Pelvic Organ Prolapse: Prospective Analysis

Robotic surgery in gynecology

Robotic surgery

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