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

• Authors: Catherine O. Hudson, Emory University; Gina Northington, Emory University; Robert Lyles, Emory University; Deborah Karp, Emory University
• Journal Title: Female Pelvic Medicine and Reconstructive Surgery
• Volume: Volume 20, Number 5
• Publisher: Lippincott, Williams & Wilkins | 2014-09-01, Pages 252-260
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/SPV.0000000000000070
• Subjects: Health Sciences, Obstetrics and Gynecology; Biology, Biostatistics
• Keywords: sacrocolpopexy; robotics; pelvic organ prolapse; mesh erosion

Abstract

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. Metaanalysis yielded a combined estimated success rate of 98.6% (95% confidence interval, 97.0%Y100%). The combined estimated rate of mesh exposure/erosion was 4.1% (95% confidence interval, 1.4%Y6.9%), and the rate of reoperation formesh 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.