title: A review of the current status of laparoscopic and robot-assisted sacrocolpopexy for pelvic organ prolapse.
abstract: BACKGROUND
  Abdominal sacrocolpopexy (ASC) represents the superior treatment for apical pelvic organ prolapse (POP) but is associated with increased length of stay, analgesic requirement, and cost compared with transvaginal procedures. Laparoscopic sacrocolpopexy (LSC) and robot-assisted sacrocolpopexy (RSC) may offer shorter postoperative recovery while maintaining equivalent rates of cure.
  
  
  OBJECTIVE
  This review evaluates the literature on LSC and RSC for clinical outcomes and complications.
  
  
  METHODS
  A PubMed search of the available literature from 1966 to 2013 on LSC and RSC with a follow-up of at least 12 mo was performed. A total of 256 articles were screened, 69 articles selected, and outcomes from 26 presented. A review, not meta-analysis, was conducted due to the quality of the articles.
  
  
  RESULTS
  LSC has become a mature technique with results from 11 patient series encompassing 1221 patients with a mean follow-up of 26 mo. Mean operative time was 124 min (range: 55-185) with a 3% (range: 0-11%) conversion rate. Objective cure was achieved in 91% of patients, with similar satisfaction rates (92%). Six patient series encompassing 363 patients treated with RSC with a mean follow-up of 28 mo have been reported. Mean operative time was 202 min (range: 161-288) with a 1% (range: 0-4%) conversion rate. Objective cure rate was 94%, with a 95% subjective success rate. Overall, early outcomes and complication rates for both LSC and RSC appeared comparable with open ASC.
  
  
  CONCLUSIONS
  LSC and RSC provide excellent short- to medium-term reconstructive outcomes for patients with POP. RSC is more expensive than LSC. Further studies are required to better understand the clinical performance of RSC versus LSC and confirm long-term efficacy.
  
  
  RESULTS
  Laparoscopic and robot-assisted sacrocolpopexy represent attractive minimally invasive alternatives to abdominal sacrocolpopexy. They may offer reduced patient morbidity but are associated with higher costs.
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York, NY, USA. Electronic address: ril9010@med.cornell.edu.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Lee
authors.affiliation: Department of Urology, O.L.V. Clinic, Aalst, Belgium; O.L.V. Vattikuti Robotic Surgery Institute, Melle, Belgium.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mottrie
authors.affiliation: Department of Urology, Stanford University, Palo Alto, CA, USA.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Payne
authors.affiliation: Department of Urology, University Hospital of Liège, Liège, Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Waltregny
mesh_terms: D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D061646:Operative Time; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics; D012447:Sacrum / Q000601:surgery; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery
keywords: Female; Genitalia; Laparoscopy; Minimally invasive; Pelvic organ prolapse; Robotics; Sacrocolpopexy; Surgical procedures