Outcomes of single port robotic sacrocolpopexy compared with multi-port approaches

Abstract

Importance

Scientific literature currently lacks data on surgical outcomes of single-port robotic sacrocolpopexy compared with traditional multi-port approaches.

Objectives

To evaluate feasibility and surgical outcomes for the single-port robotic approach to sacrocolpopexy when compared with traditional multi-port approaches.

Study design

Retrospective chart review of fifty patients who underwent minimally invasive sacrocolpopexy with a single urogynecologist between 2018 and 2021 ​at an academic tertiary care hospital. Patients were divided into three cohorts: laparoscopic multi-port (LMP), robotic multi-port (RMP), and robotic single-port (RSP). Outcome measures were operative time, number of adverse events, and severity of adverse events by Clavien-Dindo.

Results

All patients underwent at least one concomitant procedure; however, LMP had more concomitant procedures compared to RMP and RSP (p ​< ​0.001). RMP had higher incidence of prior hysterectomy (p ​< ​0.001) and prior vaginal surgery (p ​= ​0.002) compared to LMP and RSP. There were no significant differences in age, BMI, ethnicity/race, pre-operative POPQ stage, number of prior laparoscopies/laparotomies, or prior hernia repair. Linear and Poisson regression models were used to assess between-group differences in the outcome measures while adjusting for confounders. LMP had significantly higher adverse event severity than RSP (RR ​= ​2.23, p ​= ​0.044). 62.5% of the RSP group had no adverse events. No other statistically significant differences were observed.

Conclusion

This retrospective study demonstrates feasibility and safety of the single-port robotic approach for sacrocolpopexy when compared with traditional multi-port approaches. Larger, prospective studies are indicated to better understand post-operative outcomes.