Robotic-Assisted Sacrocolpopexy: How Helpful It Is, Risks & How to Prepare

As the name suggests, robotic sacrocolpopexy is a type of surgery that experts perform with robotic assistance. It mainly treats those suffering from POP or pelvic organ prolapse.

To know more about this surgical process, continue reading.

As mentioned above, this surgery is planned as a way to repair pelvic organ prolapse. This medical condition happens when any female pelvic organs, vagina, bladder, uterus or rectum descend from their original position. In this condition, one or more organs can descend, which can occur if or when the tissues loosen.

This surgery is then operated to pull up the tissue and place the organs in their original position. Unlike many surgeries, this is barely invasive and only performed when patients are under complete anaesthesia.

When a woman who is planning for pregnancy wants to correct vaginal vault prolapse, doctors suggest a non-surgical process. However, if an individual is inserting pessary into the vagina or pelvic floor, exercises do not work. Only then do experts discuss the robotic sacrocolpopexy.

One should consider undergoing this surgery if she experiences any of the following symptoms:

• Feeling some pressure or fullness in the vagina
• Severe prolapse after hysterectomy
• Swelling or a bump in the vagina or tissue projecting outwards from the vagina
• Pain while having sexual intercourse
• Urine leakage with coughing, sneezing or laughing
• Chronic constipation
• A sudden need to urinate or urine continence

If your health condition requires you to go through surgery, make sure to consult with your healthcare provider.

Here is a list of things you need to follow before the surgical process.

1. Inform your doctor about all medications you take, including prescribed and over-the-counter ones. In addition, with herbs, vitamins or supplements that you consume.
2. If you smoke and/or consume alcohol, you need to stop that because it delays healing. You can talk to your doctor if you have difficulty quitting smoking.
3. Ensure you do not eat or drink after midnight on the night before surgery.
4. Do not forget to mention your healthcare provider about any lifestyle changes that you made recently.
5. Follow every specific instruction made by your doctor before as well as after the robotic sacrocolpopexy.

Besides preparing by following the guidelines mentioned above, you also need to do certain tests before the surgery. Some of them are as follows:

• Electrocardiogram or ECG to check your heart rhythm.
• Chest X-ray for the assessment of your heart and lungs.
• Urine sample to check for any infection and other factors.
• Various blood tests to check for any infection, anaemia or kidney problems.

Whether it needs minor invasion during surgery or not, a risk factor persists after every surgical process. This procedure is no exception. Nevertheless, the risk factors associated with these surgeries mostly vary depending on your age, health and severity of your medical condition. This is why discussing all the risks and other factors before the surgery is essential.

Some of the common risks of robotic sacrocolpopexy include the following;

1. Infection
2. Uncontrollable bleeding
3. Blood clotting can sometimes travel to the lungs, causing breathing difficulties
4. Injuring nearby organs during the process
5. Wounds taking time to heal
6. Pain associated with sexual intercourse
7. Using mesh leads to inflammation in the vagina
8. Adverse reaction to anaesthesia
9. Organs do not stay in place
10. Re-emergence of prolapse symptoms
11. Movement of the mesh
12. Requirement for more surgery

Your doctor might suggest a few tests before the procedure. For instance, depending on the condition, you can expect to go through an electrocardiogram, urine sample test, chest x-ray, or blood tests. Besides this, to prepare for this, you might be suggested to –

• Stop drinking or eating before the test day.
• Stop smoking as it delays healing.

Either an obstetrician/gynaecologist (OB/GYN) or urology surgeon performs this surgical process. Nevertheless, your healthcare provider will explain the process of this surgery.

You can expect the following things to happen during robotic sacrocolpopexy.

1. General anaesthesia will be injected to prevent any pain. Hence you will sleep throughout the process.
2. A healthcare expert will continuously monitor your vitals during the process.
3. Depending on the doctors’ call, you will intake an antibiotic before and after the surgery to prevent any infection.
4. The surgeon will then make minor incisions in your lower abdomen.
5. These incisions are made to pass tools inside your system. The tool will have a small camera, a light and several minute robotic tools.
6. Once the tool is inside your body, the surgeon will use a controller to guide the movement of this tool to guide certain parts of the surgery.
7. If you are prescribed for a hysterectomy, the surgeon will first remove your uterus.
8. There are instances when a healthcare provider will talk to you about whether to keep the cervix in place to avoid further complications.
9. The surgeon will then lift the prolapsed vaginal part.
10. A tissue graft or synthetic mesh is stitched onto the organs that have prolapsed. This ensures they stay in place. The tissue graft or mesh is fixed with stronger tissue in the pelvic area.
11. Other than these steps, there can be other additional steps to repair other tissues, such as a prolapsed rectum or bladder.
12. After completing the procedure and removing all the tools from your body, the surgeon will stitch those incisions.

You will be required to stay in the hospital for a couple of days post-surgery as your vitals need careful and continuous monitoring. Additionally, you may expect the following things to happen after this surgery.

1. Pain after this procedure is normal, and your healthcare provider will give you certain medications after the operation to relieve the pain.
2. Depending on your condition, doctors will guide you on how to resume your normal diet.
3. Moving after robotic sacrocolpopexy is necessary. Otherwise, there is a chance of blood clotting.
4. Your healthcare provider will teach you some breathing exercises, which will eventually help expand your lungs.
5. There is a chance of minor fluid leakage from the incision. However, if the amount of fluid leakage increases, immediately inform your doctor. You should also check for any redness or warm sensation around the incision.
6. You must call your doctor if you develop a fever, heavy bleeding, trouble breathing, and severe pain.
7. Whatever instructions your healthcare provider suggests about the wound and medicines, you must follow them.
8. Doctors will ask you to limit your movement and sexual activities.
9. Never miss any follow-up appointments.

In most cases, after the robotic-assisted sacrocolpopexy, prolapse symptoms completely disappear. If it does not, and they return to you, then you may need to again consult with a doctor and share afterwards.

You can call your doctor if:

• You are experiencing pressure or fullness in your vulva
• Sudden urge to urinate
• Leaking urine while you sneeze, cough, or laugh
• You have a bulge in your vulva or a bulging tissue in your genitalia.
• Pain during coitus.
• Constipation