Robotic Sacral Colpopexy

The sacral colpopexy is a treatment for vaginal vault prolapse (herniation of the vaginal contents - uterine prolapse, enterocele and cystocele). The procedure can be performed laparoscopically, open abdominally and is now commonly performed robotically/ laparoscopically assisted. Open sacral colpopexies have shown up to 90-95% success rates (Ingrid Nygaard, MD) and is considered the gold standard for significant prolapse.

The procedure incorporates synthetic mesh to suspend the vagina internally once it is sewed to the top and bottom sides of the vagina (or uterus for a hysteropexy/uterine preservation). The opposite end of the mesh (same mesh as general surgeons use, also intra-abdominally for other types of hernia repairs) is attached to a ligament on the sacrum. Overlying tissue is sewed over to decreased risk of bowel obstruction. Cystoscopy to look inside the bladder is performed to verify the tubes from the kidneys are draining well and the bladder is intact.

The advantage of a robotic/laparosopic approach is to decrease the post operative recovery time, bleeding and pain as the procedure is performed through less than 1 cm incisions typically. There is always a risk of a conversion to an open procedure as well as bleeding, infection, failure and need for further procedures. A concomitant sling procedure and vaginoplasty may be performed if necessary.