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Is robotic sacrocolpopexy a marketing gimmick or a technological advancement?

Kim, Ja-Hong; Anger, Jennifer T

Current Opinion in Urology:
doi: 10.1097/MOU.0b013e32833aaa2b
Female urology: Edited by Larissa V. Rodriguez
Abstract

Purpose of review: Robot-assisted laparoscopic sacrocolpopexy (RALS) is a new surgical technique for the treatment of symptomatic vaginal vault prolapse that is rapidly gaining popularity among both urologists and gynecologists. This article will summarize the available published data to assess the potential advantages and disadvantages of this new procedure and its current role in female pelvic floor reconstruction.

Recent findings: The literature on RALS is limited mainly to single-institution retrospective studies, which suggest minimal morbidity, technical feasibility, and short-term efficacy comparable to open abdominal sacrocolpopexy. What remains uncertain is whether this approach will be superior to the other established minimally invasive transvaginal and laparoscopic approaches in terms of subjective and objective outcomes and quality of life. Other relevant issues, such as overall cost-effectiveness and extended application for multicompartment defects and uterine-sparing procedures, remain largely unexplored.

Summary: The use of RALS will likely continue to expand secondary to increased access and the popularity of the robotic apparatus among both surgeons and patients. Well designed large randomized multicenter comparative studies based on validated measurement instruments are needed to evaluate its advantage over conventional approaches, including open abdominal sacrocolpopexy and various transvaginal and laparoscopic techniques.

Author Information

Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA

Correspondence to Ja-Hong Kim, MD, Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 140, Los Angeles, CA 90095, USA Tel: +1 310 794 0755; fax: +1 310 794 6784; e-mail: jhkim@mednet.ucla.edu

© 2010 Lippincott Williams & Wilkins, Inc.