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Minimally Invasive Apical Sacropexy: A Retrospective Review of Laparoscopic and Robotic Operating Room Experiences

Pulliam, Samantha J. MD; Weinstein, Milena M. MD; Wakamatsu, May M. MD

Female Pelvic Medicine & Reconstructive Surgery: March/April 2012 - Volume 18 - Issue 2 - p 122–126
doi: 10.1097/SPV.0b013e31824a3995
Original Articles

Objectives Minimally invasive apical sacropexies (MI-APSC) can be performed using robotics or laparoscopy. We hypothesized that operative characteristics of MI-APSC, laparoscopic (LSC) and robotic (RSC), were similar. The objective of our study was to compare operative characteristics, objective prolapse outcomes, and robotic learning curve.

Methods Ninety-two women planning MI-APSC for treatment of apical pelvic organ prolapse from 2006 to 2010 were included in the study. The primary outcome was operative time. The secondary outcomes included estimated blood loss, rate of conversion, intraoperative complications, hospital stay, and objective prolapse outcome. We also analyzed the robotic learning curve. Statistical analysis included independent samples t test, Wilcoxon rank sum test, χ2, and multiple logistic regressions; significance was set at P < 0.05. Learning curve was graphed with moving average and analyzed with moving block technique.

Results Forty-eight RSCs and 43 LSCs were analyzed. Mean operative times were LSC, 238 ± 59 minutes; and RSC, 242 ± 54 minutes. Robotic MI-APSC setup was longer (P = 0.02). Complications, conversions, estimated blood loss and hospital stay were low and similar between groups. Patients’ characteristics were similar. Concomitant procedures produced longer operative times.

Conclusions Operating room experiences with laparoscopic- and robotic-assisted approaches to MI-APSC were similar, but setup time is longer for the robotic-assisted approach. The robotic learning curve is short for surgeons who have experience with LSC.

Robotic and Laparoscopic minimally-invasive sacropexies have comparable operative room experiences.

From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Vincent Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Reprints: Milena M. Weinstein, MD, 55 Fruit St, Founders 5, Boston, MA 02114. E-mail:

Drs Weinstein and Pulliam are co–first authors, having shared equally in the design, data collection, analysis, and writing and editing of this work.

Departmental funding was received from Vincent Memorial Obstetrics and Gynecology Service, Massachusetts General Hospital, Boston, MA.

The authors declare that they have nothing to disclose.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins