Robotic Surgery in Pelvic Organ Prolapse: A Retrospective Comparison of Ileopectopexy and Sacrocolpopexy

Pelvic organ prolapse (POP) is a common condition affecting over half of women above the age of 50. Sacrocolpopexy is a widely recognized surgical approach for apical prolapse, restoring the vaginal axis effectively. Despite its efficacy, complications such as bowel dysfunction and stress urinary incontinence (SUI) are common. Ileopectopexy, a newer technique utilizing the iliopectineal ligament, offers an alternative that may reduce complications while maintaining efficacy. This study compares the outcomes of robotic sacrocolpopexy and ileopectopexy in a tertiary care setting.

This study retrospectively analyzed the collected database of 35 patients who underwent robotic sacrocolpopexy or ileopectopexy between 2021 and 2023. Surgeries were performed using either the Da Vinci or Hugo robotic systems. Parameters studied included console time, blood loss, complications, hospital stay, recurrence rates, and follow-up duration. Data was statistically analyzed using SPSS (IBM Corp., Armonk, NY, v28.0), with a p-value of <0.05 considered significant.

Both groups had similar age distributions and presenting symptoms, most commonly complete uterine prolapse. Ileopectopexy had no complications, while sacrocolpopexy saw two vaginal lacerations. Blood loss was minimal across all cases (<100 mL). Post-operative bowel complaints were more frequent in the sacrocolpopexy group (14%), but absent in ileopectopexy. Hospital stay, console time, and additional procedures were comparable. Follow-up was longer for sacrocolpopexy (34.8 vs. 5.3 months).

Both robotic sacrocolpopexy and ileopectopexy effectively managed apical prolapse with minimal blood loss and comparable hospital stays. However, ileopectopexy showed fewer bowel complications, making it a promising alternative. More extensive studies with longer follow-ups are needed to validate these findings.