The 26-Minute Laparoscopic Sacral Colpopexy: Do We Really Need Robotic Technology?

Journal of Minimally Invasive Gynecology
John R Miklos, Robert D Moore

Abstract

To demonstrate the technical steps of a laparoscopic sacral colpopexy (LSC), demonstrate the efficiency of LSC, review the comparative LSC and robotic-assisted sacral colpopexy (RSC) literature, and challenge surgeons' conventional wisdom regarding RSC. Use of a time-stamped video with a step-by-step explanation of the technique and slides of comparative trials and benefits of robotic surgery. Sacral colpopexy remains the gold standard surgical procedure for treating vaginal vault prolapse. It can be performed via laparotomy, laparoscopically with or without robotic assistance. Robotic technology has been marketed based on unsubstantiated claims, including better visualization, smaller incisions, less blood loss, and greater efficiency. Conventional wisdom suggests that robotic-assisted laparoscopic surgery is easier and thus faster for the practicing surgeon. A time-stamped video of LSC in a woman with vaginal vault prolapse was performed in 26 minutes using 14 sutures in the vagina and 2 sutures in the presacral ligament. The stopwatch began after placement of the scope in the abdomen and before placement of the 3 accessory posts and ended with peritoneal closure over the sacral colpopexy mesh. The patient signed a consent an...Continue Reading

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