Does the symptomatic recurrence rate differ betweenrobotic-assisted and traditional laparoscopicsacrocolpopexy?

Abstract: BACKGROUNDApical vaginal prolapse involves descent of the uterus or the vaginal vault post-hysterectomy.Treating apical vaginal prolapse surgically is associated with a high risk of recurrence. Todate there is no consensus on how to best surgically treat apical vaginal prolapse.OBJECTIVETo compare the surgical outcomes of conventional laparoscopic sacrocolpopexy and roboticassistedlaparoscopic sacrocolpopexy for apical vaginal prolapse.METHODSThis retrospective cohort study was conducted among 435 women treated for apical vaginalprolapse with laparoscopic or robotic surgery between January 1st, 2015, and December 31st,2018. Data was obtained from medical files. The primary outcome was a sensation of vaginalbulge up to two years after surgery. Secondary outcomes were operative time, conversionrate, length of stay and reoperations. RESULTSA final data set of 104 women were included (robotic n=47; laparoscopic n=57). Totaloperative time was significantly longer in the robotic group compared to the laparoscopicgroup (143,2 ± 63,5 vs 58,7 ± 10,6 minutes, P=5e-09). Women in the robotic group also hada significantly higher frequency of length of stay >2 days at the hospital after surgery (27,6 %vs 1,8 %, P=0,02). Finally, it could not be proven to be a significant difference between thegroups regarding vaginal bulging symptoms up to two years after surgery, nor regardingreoperations or conversion rate.CONCLUSIONIt was not possible to determine a statistically significant difference in sensation of vaginalbulge up to two years after surgery between robotic-assisted and traditional laparoscopicsacrocolpopexy.