What is sacrocolpopexy?
A robot assisted sacrocolpopexy is a surgical procedure used to correct apical pelvic organ prolapses that presents with or without anterior/posterior wall defects. The term apical means “top” or “apex”. There are three types of apical prolapses:
Enterocele – The small intestine drops and bulges into the upper back wall of the vagina.
Uterine – The uterus drops into the vagina.
Vaginal vault – The vagina drops or turns in on itself and protrudes out of the vaginal opening.
A robot assisted sacrocolpopexy is a minimally invasive procedure in which several small incisions are made in the patient’s abdominal region to give access to robotically controlled surgical instruments. Robotic surgery gives the surgeon technological advantages including better visualization and magnification of the surgical area, more flexibility and precise maneuvering during the operation. Robot assisted sacrocolpopexy has documented benefits compared to open and laparoscopic surgical techniques including: the potential for less pain and blood loss, minimized complications, shorter hospital recovery, and smaller scars at the entry points.
When is sacrocolpopexy recommended?
A robot assisted sacrocolpopexy is recommended for correcting the pelvic organ prolapse, and to relieve symptoms associated with a prolapse. Many symptoms are bothersome and may not be relieved by treatments such as pelvic floor rehabilitation or pessary placement. Symptoms may include:
- A feeling of pressure or fullness in the vagina that is caused by the organ that has prolapsed.
- Stress incontinence – Urinary leakage triggered by a stressor such as laughing, coughing, sneezing, running, lifting.
- Discomfort caused by a bulge in the vagina.
- Discomfort if the vagina bulges outside the vaginal opening.
- Urinary urgency.
- Constipation associated with an intestinal prolapse.
- Painful intercourse.
What happens during a robot assisted sacrocolpopexy?
In very simple terms, the goals of this procedure is to lift the prolapsed organ, secure it into place, and relieve symptoms. Sacrocolpopexy is performed under general anesthesia in a hospital or surgical center. At the beginning of the operation, the surgeon makes several incisions in the abdomen to give access to the robotic tools. They will then lift the prolapse and secure the organ into place with either a synthetic mesh or a graft made out of the patient’s tissue. The mesh or graft is secured to bone in order to hold the organ into place.
Prior to the procedure
Prior to surgery, the patient will typically undergo pre-operative testing which may include imaging, lab work and possible cardiac clearance. The surgeon will advise individual patients about the discontinuation of blood-thinning medicines, dietary restrictions, and if bowel preparation is necessary.
Possible risks and complications
As with any surgical procedure, there are possible risks. Because the robot assisted sacrocolpopexy is less invasive than other surgeries, the patient should generally encounter milder aftereffects. Following surgery, the patient may experience bleeding, blood clots, organ injury, organ or mesh/graft movement, infection, inflammation, urinary changes.
If you are experiencing infection related symptoms, such as fever, ongoing pain, tenderness, or burning at the incision site(s), contact our office as soon as possible. In addition, notify the surgeon if you experience severe nausea, vomiting, or the inability to urinate (urinary retention). Finally, if the patient has on-going or large amounts of blood in their urine, they should also contact our office.