Factors associated with intraoperative conversion during robotic sacrocolpopexy

Area of Science:

• Urogynecology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Robotic sacrocolpopexy (RSC) is a common procedure for pelvic organ prolapse.
• Intraoperative conversion to open surgery can occur, impacting patient outcomes.
• Identifying predictors of conversion is crucial for surgical planning.

Purpose of the Study:

• To identify clinical factors predicting intraoperative conversion from RSC to open abdominal sacrocolpopexy.
• To assess the association between patient comorbidities and surgical history with conversion risk.

Main Methods:

• Retrospective review of 83 patients undergoing RSC for vaginal vault prolapse.
• Evaluation of clinical variables: age, BMI, hypertension, diabetes, tobacco use, prior surgery, and year of surgery.
• Statistical analysis to determine predictors of conversion.

Main Results:

• 17% (14/83) of RSC cases required conversion to open surgery.
• Higher body mass index (BMI) was significantly associated with increased conversion risk (median 30.2 vs. 25.8 kg/m²).
• Conversion rates increased progressively with higher BMI categories (≤25, 25-29.9, ≥30 kg/m²).

Conclusions:

• Elevated BMI is the sole significant predictor of intraoperative conversion during RSC.
• Preoperative identification of high BMI can inform patient counseling and surgical approach selection.
• This finding may help optimize patient selection for robotic sacrocolpopexy.