Robotic-Assisted Sacrocolpopexy

What is robotic-assisted sacrocolpopexy?

Robotic-assisted sacrocolpopexy is a type of surgery. It is done to repair pelvic organ prolapse. The surgery is done with special tools.

Your pelvis is the set of bones in the lower part of your belly (abdomen). Just above the pelvis there are several organs. These include the uterus, the bladder, and the lower part of your intestines. Strong tissues help hold these organs in place. If the tissues weaken, one or more of these organs may drop down and press against or bulge into the vagina. This is called pelvic organ prolapse. One type of pelvic organ prolapse is called vaginal vault prolapse. This is when the upper part of the vagina folds down into the lower part. This can happens after a hysterectomy.

Robotic-assisted sacrocolpopexy is one type of surgery to repair this problem. It is done to pull up the tissues and move the organs back into place. It is a minimally invasive method. This means it uses smaller incisions than a standard surgery. It’s done while you’re asleep under general anesthesia.

During the surgery, your doctor will put small tools and a tiny camera through small incisions on your lower belly. This gives your doctor a better view of the area in your body. Your doctor moves the tools using a robotic controller. This lets your doctor to do very small movements with the tools. A graft of tissue or synthetic mesh is sewn under the pelvic organs. This helps keep them in place. The tools are then removed. The incisions are closed and bandaged.

Robotic-assisted sacrocolpopexy has some benefits over other methods. It may have a lower risk of complications for some people. It can lead to a shorter hospital stay and a faster recovery time.

This surgery may not be available in all areas. Robotic surgery is often more expensive than other methods. It can take longer than other types of surgery. Your doctor can help you decide which surgery will work best for you.

Why might I need robotic-assisted sacrocolpopexy?

Robotic-assisted sacrocolpopexy can help relieve the symptoms of pelvic organ prolapse, such as:

  • Fullness or pressure in the vagina
  • A bulge in the vagina or tissue bulging out from the vagina
  • Leaking urine with coughing, sneezing, or laughing
  • Sudden urges to urinate
  • Constipation
  • Pain with intercourse

Pelvic organ prolapse can sometimes be treated without surgery. These treatments can include pelvic floor exercises or the use of a pessary. A pessary is a small device inserted into the vagina to provide support. Your doctor may advise surgery if these options don’t work, or if you have moderate to severe prolapse. Your doctor may advise you to have the surgery only if you do not plan to have children in the future.

If you decide to have surgery, you may have certain options. For example, some women choose to have their uterus removed (hysterectomy) as part of their surgery. The best type of surgery for you may vary depending on the severity and location of your prolapse. Your doctor can help you decide which type of surgery may be best for you.

What are the risks for robotic-assisted sacrocolpopexy?

Every surgery has risks. The risks of robotic-assisted sacrocolpopexy include:

  • Infection
  • Excess bleeding
  • Blood clots that can travel to the lungs and cause breathing problems
  • Injury to nearby organs such as the bowel or ureters
  • Wound healing problems
  • Pain during intercourse
  • Inflammation in the vagina if mesh is used
  • Reaction to anesthesia
  • Failure of the organs to stay in place
  • Return of prolapse symptoms
  • Movement of the mesh
  • Need for additional surgery

Your risks may vary depending on your age, your overall health, and the severity and type of your prolapse. Before the surgery, talk with your doctor about all of your concerns.

How do I prepare for a robotic-assisted sacrocolpopexy?

Talk with your doctor how to prepare for your surgery. Tell your doctor about all the medications you take. This includes over-the-counter medications such as aspirin. You may need to stop taking some medications ahead of time, such as blood thinners. If you smoke, you’ll need to stop before your surgery. Smoking can delay healing. Talk with your doctor if you need help to stop smoking.

Do not eat or drink after midnight the night before your surgery. Tell your doctor about any recent changes in your health, such as a fever.

You may need to have tests before your surgery such as:

  • Electrocardiogram, to evaluate your heart rhythm
  • Chest x-ray, to assess your heart and lungs
  • Urine sample, to test for infection and other factors
  • Blood tests, to check for infection, anemia, and kidney function

Your doctor might give you more instructions about how to prepare.

What happens during a robotic-assisted sacrocolpopexy?

Your doctor can help explain the details of your surgery. An obstetrician/gynecologist (OB/GYN) surgeon or a urology surgeon and a team of specialized nurses will perform your surgery. In general, you can expect the following:

  • You will be given general anesthesia. This prevents pain and causes you to sleep through the surgery.
  • A healthcare provider will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.
  • You may be given antibiotics before and after the surgery. This is to help prevent infection.
  • The doctor will make a few small incisions on your lower abdomen.
  • The doctor will pass tools through the small incisions. These include a tiny camera with a light, and several robotic tools.
  • Your doctor will use the robotic controller to move the tools and remove the fibroids.
  • If you are going to have a hysterectomy, the doctor will remove your uterus first.
  • The doctor will then lift up the prolapsed portion of the vagina.
  • A graft of tissue or synthetic mesh is sewn under the pelvic organs. This helps keep them in place. The graft or mesh is anchored with sutures to strong tissue in the pelvic area.
  • Additional steps may be done to repair a prolapsed rectum, bladder, or other tissues.
  • When the surgery is done, the tools will be removed. The incisions will be closed and bandaged.

What happens after a robotic-assisted sacrocolpopexy?

After the surgery, your vital signs will be watched. You may need to stay overnight in the hospital. When you’re ready to go home, you’ll need to have someone drive you.

You may have some pain after the surgery. You can have pain medication as needed. You can resume a normal diet as soon as you are able to.

Moving around as soon as possible after surgery can help prevent problems such as blood clots. You may need to do breathing therapy to help expand your lungs after surgery.

You may also have some fluid leaking from the incisions. Tell your doctor if there is a lot of fluid, or the incisions are red or warm. Call your doctor right away if you have a fever, heavy menstrual bleeding, severe pain, difficulty breathing, or other severe symptoms.

Follow all of your doctor’s instructions about wound care and medications. Limit your movement and sexual activity as advised. You might need to have stitches removed at a follow-up appointment. Make sure to go to all of your follow-up appointments.

Your prolapse symptoms may go away completely after surgery. Talk with your doctor if your symptoms do not go away, or if they return.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure