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Insufflation Pressure and Pain After Single-Port Robotic Sacrocolpopexy
Sarah Ashmore1, Iris Burgard, Douglas Russo
1Section of Urogynecology and Reconstructive Pelvic Surgery, University of Chicago, Chicago, IL.
Urogynecology (Philadelphia, Pa.)
|March 19, 2026
Summary
Lowering insufflation pressure during single-port robotic sacrocolpopexy significantly reduced postoperative pain. This approach decreased pain scores on postoperative day 1 without negatively impacting surgeon visualization.
Area of Science:
- Minimally Invasive Surgery
- Gynecologic Surgery
- Robotic Surgery
Background:
- Pneumoperitoneum can cause peritoneal irritation and referred pain after surgery.
- Optimizing intraoperative conditions is crucial for patient outcomes.
Purpose of the Study:
- To evaluate if reducing insufflation pressure during single-port robotic sacrocolpopexy alleviates postoperative pain.
- To assess the impact of lower insufflation pressure on surgeon visualization during the procedure.
Main Methods:
- A double-blinded randomized trial compared 15 mm Hg (standard) versus 12 mm Hg (experimental) insufflation pressure.
- Postoperative day 1 pain was assessed using a Numeric Rating Scale (NRS).
- Surgeon visualization was recorded as a secondary outcome.
Main Results:
- Lower insufflation pressure (12 mm Hg) was associated with significantly lower postoperative day 1 pain scores (26 vs 50, P < 0.001).
- Surgeon visualization remained unchanged in 97.2% of cases.
- Seventy-one participants were randomized.
Conclusions:
- A 3 mm Hg reduction in insufflation pressure effectively decreases postoperative pain.
- Lowering insufflation pressure is a safe method that does not compromise surgical visibility.
