Single-Site Robotic Assisted Laparoscopic Sacrocolpopexy with Supracervical Hysterectomy

Abstract

Single-site surgery is a logical next step in the evolution of minimally invasive surgery and is being utilized to perform increasingly complex procedures in both traditional laparoendoscopic as well as robotic assisted approaches. We report the first use of Robotic assisted Laparoendoscopic single-site (LESS) surgery for completion of sacrocolpopexy (SCP) as treatment for pelvic organ prolapse. The Da Vinci Single-Site surgical system allows 8.5mm endoscope, 5mm assistant access, and two curved cannulae which can can hold various instruments such as the monopolar hook, bipolar forcep, scissors, and suction. A Y-mesh was attached to vaginal walls and sacral promontory. R-LESS SCP is feasible and does not compromise the surgical technique of a sacrocolpopexy. It also results in superior cosmesis. However this technique had increased operative time and blood loss. Both of these disadvantages can be remedied as we increase our experience with this technique.