Comparison of Perioperative and Postoperative Outcomes between Single-Port Robotic Sacrocolpopexy and Multi-Port Approaches.

Abstract

Introduction and hypothesis: To evaluate the feasibility and perioperative outcomes of single-port robotic (RSP) sacrocolpopexy (SCP) in comparison to the multi-port approach (RMP).

Methods: This was a retrospective cohort study set at an academic, tertiary care center. The primary outcome was operative time (incision to closure) and the secondary outcomes included number and severity of complications. Medical charts were reviewed of patients who had undergone a robotic SCP between March 2018 and December 2024. Differences were tested using Mann-Whitney U tests, Fisher's exact tests, and multivariable regression models.

Results: One hundred and eighty-one eligible cases were included. Among them, 109 patients underwent RMP, and 72 patients underwent the RSP approach. For operative time, RSP SCP was statistically significantly shorter than RMP SCP by 40 min (216 versus 176 min, p < .001). The hospital length of stay was shorter for the RSP group (11.0 versus 17.0 h, p < .001), while EBL showed no difference between groups (p = 0.18). No conversion to laparoscopy or laparotomy was found in both groups. Number and severity of adverse events assessed by Clavien-Dindo classification were similar and overall complication rates and complications requiring surgical correction under anesthesia did not show a difference (Clavien-Dindo Grade III, RMP 11.0% vs RSP 5.6%, p = 0.58). Median follow-up was 15.2 weeks postoperatively, and there were no significant differences in reoperation within 30 days, mesh erosion, prolapse recurrence and subsequent reoperations due to the recurrence.

Conclusions: Single-port robotic sacrocolpopexy is a safe and feasible minimally invasive technique to address apical pelvic floor prolapse.