Comparing Postoperative Pain With Laparoscopic Versus Robotic Sacrocolpopexy

Area of Science:

• Urogynecology
• Minimally Invasive Surgery
• Surgical Outcomes Research

Background:

• Minimally invasive sacrocolpopexy (MISC) is a surgical treatment for pelvic organ prolapse.
• Laparoscopic (LS-MISC) and robotic (R-MISC) approaches are common MISC techniques.
• Postoperative pain and opioid use are key outcomes following MISC.

Purpose of the Study:

• To compare postoperative pain and pain-related outcomes between LS-MISC and R-MISC.
• To analyze opioid consumption and visual analog scale (VAS) pain scores at 24 hours and 7 days post-procedure.

Main Methods:

• Secondary analysis of a multicenter, randomized controlled trial (RCT) involving 90 women undergoing MISC.
• Coprimary outcomes included total opioid use (morphine milligram equivalents - MMEs) and VAS pain scores at 24 hours.
• Secondary outcomes assessed pain via diary through 7 days and quality of life.

Main Results:

• No significant differences in 24-hour VAS pain scores or weekly opioid use between LS-MISC and R-MISC.
• LS-MISC had longer operative times and hospital stays.
• Initial higher opioid consumption in LS-MISC disappeared after adjusting for operative time and concomitant procedures.

Conclusions:

• Postoperative pain, opioid usage, and quality of life are comparable between LS-MISC and R-MISC.
• Adjusting for confounding factors like operative time eliminates observed differences in opioid consumption.
• Overall, pain and opioid use were low regardless of surgical approach.