Outcomes of Laparoscopic versus Robotic-Assisted Sacrocolpopexy for Pelvic Organ Prolapse-A Comprehensive Retrospective Analysis.

Abstract

Introduction and hypothesis: Minimally invasive abdominal sacrocolpopexy (SC) is the gold standard for managing symptomatic pelvic organ prolapse (POP). Robot-assisted laparoscopy (RSC) offers a promising surgical option compared to conventional laparoscopy (LSC). This study compares the clinical and operative outcomes of these techniques to determine if RSC is superior to LSC.

Methods: We conducted a retrospective, single-center study in the Gynecology Department at the Citadelle Hospital in Liège, Belgium. Data from all patients who underwent SC between January 2019 and December 2023 were collected. We evaluated demographic and clinical data, perioperative complications, operative time (OT), length of stay, risk of recurrence and follow-up duration. Statistical analysis was performed to compare outcomes between the groups.

Results: Data from 208 patients (97 LSC and 111 RSC) were analyzed. No significant differences were found between the groups. A higher body mass index trend was observed in the RSC group (mean BMI: 26.63, range: 20-43) compared to the LSC group (mean BMI: 25.45, range: 15-34; p = 0.0625). The median OT was similar (LSC: 111 min vs RSC 119 min; p = 0.104), with a notable reduction in OT compared to the literature. Additionally, more RSC procedures could be performed per day (3 RSC vs. a maximum of 2 for LSC).

Conclusion: Robot-assisted laparoscopy was not demonstrated to be superior to LSC. However, both procedures had comparable OT, significantly shorter than previously reported. RSC's operational efficiency might allow for a higher number of daily procedures, translating into practical benefits in clinical settings.