This operation is performed in women who have pelvic organ prolapse. Pelvic organ prolapse is a condition in which the normal muscular and tendinous supports of the vagina, uterus, bladder and rectum are weakened. This causes some or all of these organs to drop down below the normal level in the pelvis causing symptoms of pain, bleeding, difficulty urinating and difficulty emptying the bowel. Surgery for this has traditionally been done by open or laparoscopic keyhole surgery to lift these organs back into the correct anatomical position with the assistance of surgical mesh as a mechanical support.
Robotic sacrocolpopexy takes this operation to the next level with a great degree of finesse and dexterity that keyhole robotic surgery allows. The operation involves the placement of a surgical mesh in the posterior part of the abdominal cavity. This is attached to the ligaments next to the sacrum and the lower part of the mesh is attached to the pelvic floor muscles and the uterus, and or bladder, to allow these to be raised into the normal anatomical positions.
The operation takes 60-90 minutes to complete. The patients are usually discharged the following day. A catheter is left in the bladder overnight and the incisions are all under 2cm allowing a rapid recovery.
The risks of the operation include the usual risks of surgery of bleeding, infection, pain and ileus (the intestines stop working for 12-24 hours). These are usually uncommon. More specific risks of the procedure include damage to the wall of the bladder or wall of the bowel. This is uncommon but sometimes needs repair with an open operation or keyhole surgery. Your surgeon will discuss this with you if it is a possible risk factor prior to the surgery.
This operation has very good long-term results and very few women need a repeat procedure. Most of the mesh is placed in the posterior part of the abdomen under the cover of the lining of the abdominal cavity and this stops it interfering with or becoming stuck to the bowel in the future.