Medium Term Outcomes for Robotic Sacral Colpopexy With Autologous Fascia Lata

Area of Science:

• Urogynecology
• Minimally Invasive Surgery
• Pelvic Reconstructive Surgery

Background:

• Apical pelvic organ prolapse (POP) significantly impacts women's quality of life.
• Surgical correction often involves native tissue repair or synthetic mesh augmentation.
• Autologous fascia lata presents a biological alternative to synthetic materials for POP repair.

Purpose of the Study:

• To evaluate the medium-term outcomes of robotic sacral colpopexy (RSC) utilizing autologous fascia lata for apical POP.
• To assess the durability, recurrence rates, and patient-reported outcomes following this procedure.

Main Methods:

• Retrospective review of patients undergoing RSC with autologous fascia lata (Nov 2017-Aug 2022).
• Inclusion criteria required a minimum of 24 months follow-up.
• Data included demographics, operative details, complications, POP-Q measurements, UDI-6, and IIQ-7 scores.

Main Results:

• Nineteen patients with a mean follow-up of 42.8 months were analyzed.
• Significant improvements in Pelvic Organ Prolapse Quantification (POP-Q) values were observed.
• Low recurrence rates (6.3% posterior, 6.3% apical) and high patient satisfaction with UDI-6/IIQ-7 scores were reported. Minor, self-limiting complications from fascia lata harvest occurred.

Conclusions:

• Robotic sacral colpopexy with autologous fascia lata demonstrates durable medium-term efficacy for apical POP.
• This technique offers favorable anatomic and symptomatic outcomes with low recurrence and retreatment rates.
• Autologous fascia lata is a viable alternative to synthetic mesh, though larger studies are warranted.