title: Surgical management of apical pelvic support defects: the impact of robotic technology.
abstract: OBJECTIVE
  Our aim was to determine what effect access to robotic technology had on our approach to managing apical pelvic support defects.
  
  
  METHODS
  This was a retrospective chart review of 187 pelvic floor reconstructive surgeries performed for the 18 months prior to (time period 1: January 2007 to July 2008) and following (time period 2: July 2009 to December 2009) the introduction of the robot. Chi-square was used to compare percentages, and analysis of variance (ANOVA) was used to compare demographic data among groups.
  
  
  RESULTS
  Overall, 187 procedures were performed for apical prolapse during the study period: 61 in time period 1 and 126 in time period 2. Following the introduction of robotic technology, a significant change from vaginal to abdominal reconstruction occurred. Uterosacral ligament suspension declined from 67 % to 22 % (p < 0.0001), whereas sacrocolpopexy increased from 25 % (15/61) to 66 % (83/126) (p < 0.0001). The rate of abdominal sacrocolpopexy, however, declined from 25 % (15/61) to 2 % (2/126) over the two time periods (p < 0.0001).
  
  
  CONCLUSIONS
  The introduction of robotic technology significantly affected the surgical procedure and mode of surgical access for repair of apical pelvic support defects.
authors.affiliation: Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System, Richmond, VA, USA.
authors.forename: Ashley W
authors.initials: AW
authors.lastname: Carroll
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lamb
authors.forename: Audra Jo
authors.initials: AJ
authors.lastname: Hill
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Gill
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews
mesh_terms: D000005:Abdomen / Q000601:surgery; D000290:Adnexa Uteri / Q000601:surgery; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000639:trends*; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000639:trends*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000639:trends*; D014621:Vagina / Q000601:surgery