title: Robotically assisted laparoscopic repair of anterior vaginal wall and uterine prolapse by lateral suspension with mesh: initial experience and video.
abstract: OBJECTIVE
  Sacral colpopexy/hysteropexy is a well-established approach to vaginal apex support and was the first technique used to treat pelvic organ prolapse (POP) with robotic assistance. However, dissection at the level of the promontory may be difficult, especially in obese patients, and associated with rare but potential serious morbidity such as life-threatening vascular injury. In an attempt to avoid this risk, we describe a new robotic approach for POP repair with lateral suspension.
  
  
  METHODS
  From March 2012 through June 2013, ten patients with symptomatic anterior vaginal wall and uterine prolapse were operated by a single surgeon. The video presents the different steps of robotically assisted laparoscopic repair of POP by lateral suspension with mesh and uterine conservation using da Vinci S or Si system.
  
  
  RESULTS
  POP repair was successfully completed in all ten patients without any perioperative or postoperative complication.
  
  
  CONCLUSIONS
  Robotically assisted laparoscopic repair of POP by lateral suspension with mesh is a novel and feasible technique with promising short-term results. It may have several theoretical advantages over sacral colpopexy/hysteropexy and may represent an alternative in cases of difficult dissection of the promontory.
authors.affiliation: Department of Gynecology and Obstetrics, Division of Gynecology, Geneva University Hospitals, Geneva, Switzerland, Patrick.Dallenbach@hcuge.ch.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dällenbach
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Veit
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D065287:Robotic Surgical Procedures / Q000379:methods*; D013526:Surgical Mesh; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery
references.citation: Gynecol Obstet Fertil. 2011 Mar;39(3):127-31
references.pmid: 21377391
references.citation: Urology. 2012 Mar;79(3):532-6
references.pmid: 22386392
references.citation: J Gynecol Obstet Biol Reprod (Paris). 1994;23(4):378-85
references.pmid: 8051364
references.citation: Ann Chir. 1967 Mar;21(5):321-8
references.pmid: 5608987
references.citation: Obstet Gynecol. 2004 Oct;104(4):805-23
references.pmid: 15458906