title: Robot-assisted sacrocolpopexy for pelvic organ prolapse: a systematic review and meta-analysis of comparative studies.
abstract: BACKGROUND
  Surgery represents the mainstay of treatment for pelvic organ prolapse (POP). Among different surgical procedures, abdominal sacrocolpopexy (SC) is the gold standard for apical or multicompartmental POP. Research has recently focused on the role of robot-assisted sacrocolpopexy (RASC).
  
  
  OBJECTIVE
  To conduct a systematic review on the outcomes of RASC.
  
  
  METHODS
  PubMed, Scopus, and Web of Science databases as well as ClinicalTrials.gov were searched for English-language literature on RASC. A total of 509 articles were screened; 50 (10%) were selected, and 27 (5%) were included. Studies were evaluated per the Grading of Recommendations, Assessment, Development, and Evaluation system and the European Association of Urology guidelines.
  
  
  RESULTS
  Overall, data on 1488 RASCs were collected from 27 studies, published from 2006 to 2013. Objective and subjective cures ranged from 84% to 100% and from 92% to 95%, respectively. Conversion rate to open surgery was <1% (range: 0-5%). Intraoperative, severe postoperative complications, and mesh erosion rates were 3% (range: 0-19%), 2% (range: 0-8%), and 2% (range: 0-8%), respectively. Surgical-related outcomes have improved with increased experience, with an estimated learning curve of about 10-20 procedures. Laparoscopic SC is less costly than RASC, although the latter has lower costs than abdominal SC.
  
  
  CONCLUSIONS
  RASC is a safe and feasible procedure for POP; it allows the execution of complex surgical steps via minimally invasive surgery without medium- and long-term anatomic detriments. Further prospective studies are needed to confirm these findings.
  
  
  RESULTS
  We looked at the outcomes of robotic sacrocolpopexy for prolapse. We found that the use of robotic technology is safe and effective for the treatment of prolapse in women.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. Electronic address: mauserati@hotmail.com.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bogani
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Sorice
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Braga
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, 2nd University of Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Torella
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Salvatore
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
mesh_terms: D003248:Constipation / Q000209:etiology; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects; D012447:Sacrum / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D014621:Vagina / Q000601:surgery*
keywords: Apical prolapse; Pelvic organ prolapse (POP); Robotic; Sacral colpopexy; Sacrocolpopexy