Simultaneous Robotic Sacrocolpopexy and Female Artificial Urinary Sphincter Implantation: Single-Session Surgical Approach

IF 2.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2026-10-01 Epub Date: 2026-02-24 DOI:10.1016/j.jmig.2026.02.033

David Carracedo Calvo MD, Miguel Toledo Jiménez MD, Tamara Jerez Izquierdo MD, Miguel Sánchez Encinas MD

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引用次数: 0

Abstract

Objective

Severe female stress urinary incontinence (SUI), particularly in the context of intrinsic sphincter deficiency, remains a challenging condition, for which the artificial urinary sphincter (AUS) is considered the most effective therapeutic option [1] as well as sacrocolpopexy represents the gold standard for durable anatomical correction and functional improvement in patients with pelvic organ prolapse (POP) [2]. Robotic surgery has expanded the possibilities of complex pelvic reconstruction by improving visualization, precision, and ergonomics [3]. The objective of this video is to demonstrate the feasibility and effectiveness of a simultaneous robotic approach combining AUS implantation and sacrocolpopexy in a single operative session.

Setting

Single-hospital experience in a robotic urology and pelvic reconstructive surgery unit.

Participants

A 62-year-old woman with severe stress urinary incontinence secondary to intrinsic sphincter deficiency confirmed by videourodynamic study and symptomatic apical pelvic organ prolapse.

Intervention

The video presents a step-by-step robotic technique in which AUS implantation and sacrocolpopexy are performed sequentially during the same surgical procedure. Particular emphasis is placed on the intercalation of key surgical steps to optimize exposure, minimize operative time, and safely address both conditions within a single session.

Conclusion

In carefully selected patients, the combination of robotic sacrocolpopexy and AUS implantation offers a comprehensive solution for the simultaneous management of apical POP and severe SUI. At 12-month follow-up, this approach resulted in complete continence and durable anatomical correction, with low morbidity and satisfactory functional outcomes. Given the established efficacy of AUS for severe female SUI [1], the durability of sacrocolpopexy for apical prolapse [2], and the technical advantages of robotic surgery in complex pelvic reconstruction [3], this single-session strategy appears to be a safe and efficient option, despite its limited representation in the current literature [4].

Video Abstract

Download: Download video (182MB)

查看原文本刊更多论文

同时机器人骶髋固定术和女性人工尿道括约肌植入术：单次手术方法。

目的：严重的女性压力性尿失禁（SUI），特别是在固有括约肌缺乏的情况下，仍然是一个具有挑战性的疾病，人工尿括约肌（AUS）被认为是最有效的治疗选择(1)，而骶colpopexy是骨盆器官脱垂（POP）患者持久解剖矫正和功能改善的金标准(2)。机器人手术通过提高可视化、精确度和人体工程学，扩大了复杂骨盆重建的可能性(3)。本视频的目的是演示在单次手术中同时采用机器人入路联合AUS植入和骶髋固定术的可行性和有效性。背景：单医院机器人泌尿外科和骨盆重建外科的经验。参与者：一名62岁女性，经视频尿动力学研究证实，继发于内在括约肌缺陷的严重压力性尿失禁和症状性盆腔器官脱垂。干预：视频展示了一种循序渐进的机器人技术，在同一手术过程中依次进行AUS植入和骶colpop固定术。特别强调的是关键手术步骤的插入，以优化暴露，最小化手术时间，并在一次手术中安全地解决这两种情况。结论：在精心挑选的患者中，机器人骶colpop固定术联合AUS植入术为同时治疗根尖POP和严重SUI提供了全面的解决方案。在12个月的随访中，该方法获得了完全的控制和持久的解剖矫正，低发病率和令人满意的功能结果。鉴于AUS治疗严重女性SUI的疗效(1)，骶colpop固定术治疗根尖脱垂的持久性(2)，以及机器人手术在复杂骨盆重建中的技术优势(3)，这种单次手术策略似乎是一种安全有效的选择，尽管其在当前文献中的代表性有限(4)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.