Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial

Area of Science:

• Urogynecology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Vaginal apex prolapse is a common condition following hysterectomy.
• Sacrocolpopexy is a surgical procedure to restore vaginal support.
• Laparoscopic and robotic-assisted approaches are utilized for sacrocolpopexy.

Purpose of the Study:

• To compare the clinical outcomes and costs of conventional laparoscopic sacrocolpopexy versus robotic-assisted laparoscopic sacrocolpopexy.
• To evaluate operative time, postoperative pain, functional recovery, and anatomical support.

Main Methods:

• A single-center, blinded randomized trial was conducted.
• Participants with stage 2-4 vaginal prolapse were randomized to either laparoscopic or robotic sacrocolpopexy.
• Outcomes assessed included operative time, pain, functional activity, symptom burden, quality of life, and cost.

Main Results:

• Robotic sacrocolpopexy demonstrated significantly longer total operative time (+67 minutes) compared to laparoscopic.
• The robotic group experienced increased postoperative pain and required longer use of NSAIDs.
• Robotic-assisted surgery incurred higher healthcare system costs (+$1,936) than the laparoscopic approach.

Conclusions:

• Conventional laparoscopic sacrocolpopexy is associated with shorter operating times, reduced pain, and lower costs compared to robotic-assisted sacrocolpopexy.
• Both surgical techniques provide comparable long-term improvements in vaginal support and functional outcomes.
• The findings suggest conventional laparoscopy may be a more cost-effective option for sacrocolpopexy.