title: Robotic-assisted laparoscopic sacrocolpopexy for stage III pelvic organ prolapse.
abstract: OBJECTIVE
  Abdominal sacrocolpopexy is the gold standard treatment for pelvic organ prolapse and can be performed laparoscopically. Robotic assistance allows optimal dissection and placement of the prosthesis. We present a video of our technique along with the results on 90 patients.
  
  
  METHODS
  We perform a posterior dissection down to the levator muscles and an anterior dissection down to the trigone. The meshes are made of polyester (mersuture®). The posterior mesh is sutured to the levator muscles, to the rectum above the anorectal junction, below the uterosacral ligaments, and to the isthmus/cervix. The anterior mesh is sutured to the vagina and the isthmus/cervix and attached to the promontory with a tension measured through a vaginal exam.
  
  
  RESULTS
  We operated on 90 patients. There was an additional procedure in 71 cases (either subtotal hysterectomy, adnexectomy, adhesiolysis, or rectopexy). The mean operative time was 246 min (180-415). Perioperative complications were one vaginal effraction and a case of sigmoidal perforation during an adhesiolysis. Early complications were two cases of bowel hernia through port sites. The mean hospital stay was 3.48 days (2-11). The mean follow-up is 15.6 months (range 1-45). Six patients have a persistent stage II prolapse. We observed no retraction of the prosthesis and no dyspareunia.
  
  
  CONCLUSIONS
  With this technique we performed a complete treatment for severe prolapse by a minimally invasive approach with a low rate of recurrence at this point.
authors: Department of Obstetrics and Gynecology, Institut Mutualiste Montsouris, 42, boulevard Jourdan, 75014, Paris, France.
authors: Christine
authors: C
authors: Louis-Sylvestre
authors: Martine
authors: M
authors: Herry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012371:Robotics; D053825:Suburethral Slings; D013526:Surgical Mesh