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Outcomes of Robotic Sacrocolpopexy: A Systematic Review and Meta-Analysis

Hudson, Catherine O. MD*; Northington, Gina M. MD, PhD*; Lyles, Robert H. PhD; Karp, Deborah R. MD*

Female Pelvic Medicine & Reconstructive Surgery: September/October 2014 - Volume 20 - Issue 5 - p 252–260
doi: 10.1097/SPV.0000000000000070
Review Article
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Objectives Robotic sacrocolpopexy has been rapidly incorporated into surgical practice without comprehensive and systematically published outcome data. The aim of this study was to systematically review the currently published peer-reviewed literature on robotic-assisted laparoscopic sacrocolpopexy with more than 6 months of anatomic outcome data.

Methods Studies were selected after applying predetermined inclusion and exclusion criteria to a MEDLINE search. Two independent reviewers blinded to each other’s results abstracted demographic data, perioperative information, and postoperative outcomes. The primary outcome assessed was anatomic success rate defined as less than or equal to pelvic organ prolapse quantification system (POP-Q) stage 1. A random effects model was performed for the meta-analysis of selected outcomes.

Results Thirteen studies were selected for the systematic review. Meta-analysis yielded a combined estimated success rate of 98.6% (95% confidence interval, 97.0%–100%). The combined estimated rate of mesh exposure/erosion was 4.1% (95% confidence interval, 1.4%–6.9%), and the rate of reoperation for mesh revision was 1.7%. The rates of reoperation for recurrent apical and nonapical prolapse were 0.8% and 2.5%, respectively. The most common surgical complication (excluding mesh erosion) was cystotomy (2.8%), followed by wound infection (2.4%).

Conclusions The outcomes of this analysis indicate that robotic sacrocolpopexy is an effective surgical treatment of apical prolapse with high anatomic cure rate and low rate of complications.

Robotic sacrocolpopexy is an effective surgical treatment of apical prolapse with high anatomic cure rate and low rate of complications.

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine; and †Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA.

Reprints: Deborah R. Karp, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory University, Woodruff Memorial Research Bldg, 1639 Pierce Dr, Room 4305, Atlanta, GA 30322. E-mail: debby.karp@emory.edu.

Dr Lyles’ work was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR000454. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have declared they have no conflicts of interest.

Financial Disclosure: no funding was received for this work.

The findings were presented orally at the 2012 International Urogynecology Association Scientific Meeting, Brisbane, Australia, September 4–8, 2012.

The findings were presented in poster format at the 2012 American Urogynecologic Society Annual Scientific Meeting, Chicago, IL, October 3 to 6, 2012.

© 2014 by Lippincott Williams & Wilkins