The robotic da Vinci sacrocolpopexy surgery (for uterine or vaginal prolapse)

The da Vinci sacrocolpopexy is a surgical system using a robotic device. The purpose is to provide minimally invasive surgery for vaginal prolapse. The robot has a main unit with four arms – three operating arms and one camera – plus a surgeon’s console.

The robot arms are like a human wrist, controlled by the surgeon at the console, able to see virtually inside the patient. The operating room team watches on, and a surgical assistant passes items, a scrub nurse passes instruments, and an anaesthetist will be present to administer and manage the anaesthetic.

A sacrocolpopexy is a procedure that inserts mesh to hold in prolapsed organs, and keep the vagina in an anatomically correct position.

The word sacro – colpos – pex The word sacrocolpopexy means to lift the vagina to the pelvic bone Sacro – the part of the spine that is in the pelvis Colpos – vagina Pex – to suspend or lift

A hysterectomy may also be performed for uterine prolapse, and for support of the vagina over the long-term. Cure rates are at about 90 per cent. The mesh supports the apex of the vagina at the front (anterior), which is the weakest part of the vaginal support system, plus supports the back of the vagina. The mesh means the vagina can only fall so far as the mesh allows. The bladder sits on the front (anterior) mesh, and the rectum is supported by the back (posterior) mesh.

Why would a surgeon use the da Vinci sacrocolpopexy?
Your surgeon will go through the surgical options with you. This is a specialised robotic machine that may not be widely available, but other options are just as good. The manufacturers state that the benefits of this machine include:

• Less blood lost, meaning less risk of transfusions being required (or fewer transfusions)
• Less risk of infection
• Less scarring
• Shorter hospital stay
• Shorter recovery time
• Faster to get back to normal activities

How is the da Vinci sacrocolpopexy different to normal sacrocolpopexy surgery?

A sacrocolpopexy is usually an open surgery. A 6-12 inch horizontal incision is made in the lower abdomen, but with the da Vinci robotic machine, there are just five small incisions. The robot ‘learns’ where is it is space to avoid tugging on the abdominal wall, meaning post-surgery soreness is diminished due to less trauma to tissue.