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Robotic presacral neurectomy - technique and results
Vasilis Kapetanakis1, Kristina Jacob, Jennifer Klauschie
1Division of Gynecologic Surgery, Mayo Clinic, Scottsdale, AZ, USA. vkapetas@yahoo.com
Summary
Robotic presacral neurectomy is a safe and feasible surgical option for chronic pelvic pain. This minimally invasive procedure demonstrated significant pain improvement in a majority of selected patients.
Area of Science:
- Minimally invasive surgery
- Gynecologic surgery
- Pain management
Background:
- Chronic pelvic pain (CPP) significantly impacts quality of life.
- Presacral neurectomy is a surgical option for CPP.
- Robotic surgery offers potential advantages in complex gynecologic procedures.
Purpose of the Study:
- To evaluate the feasibility, safety, and outcomes of robotic presacral neurectomy.
- To assess the efficacy of robotic presacral neurectomy in improving pelvic pain.
Main Methods:
- Retrospective analysis of 33 patients with midline CPP.
- Robotic presacral neurectomy performed between March 2004 and March 2010.
- Data collected on operative time, blood loss, complications, and pain outcomes.
Main Results:
- No intra-operative complications or conversions to open surgery.
- Low mean operative time (5.8 min) and blood loss (39 ml).
- High same-day discharge rate (60%) and short hospital stay (0.39 days).
- 73% of patients reported pain improvement.
- Two postoperative complications: pelvic abscess and Clostridium difficile colitis.
Conclusions:
- Robotic presacral neurectomy is a safe and feasible procedure.
- The technique is effective in improving pelvic pain for selected patients.
- Further research may explore long-term outcomes and patient selection criteria.
