NYU Langone Medical Center, Department of Urology, Division of Female Pelvic Medicine and Reconstructive Surgery, 150 East 32 Street NY, NY 10016, USA.
Curr Opin Urol. 2012 Jul;22(4):292-6. doi: 10.1097/MOU.0b013e328354809c.
Pelvic reconstructive surgeons in the fields of urology, gynecology and urogynecology have continually adapted new techniques in pelvic organ prolapse (POP) repair in order to improve both anatomic and subjective outcomes. In the last 5 years, robotic surgery has gained a strong foothold in urologic oncology, gynecologic oncology, cardiothoracic surgery and now in female pelvic medicine. Robotic surgery has made its way into the armamentarium of POP treatment and has allowed pelvic surgeons to adapt the 'gold standard' technique of abdominal sacrocolpopexy to a minimally invasive approach with improved intraoperative morbidity and decreased convalescence. This review article aims to discuss the techniques of robotic prolapse repair as well as morbidity, cost and clinical outcomes.
The adaptation of minimally invasive approaches to the treatment of POP initially began with laparoscopy, something only those surgeons with extensive and advanced laparoscopic skills are able to accomplish. Access to robotic technology makes conversion from open or laparoscopic to robotic surgery much more feasible for most pelvic floor surgeons. There are currently no published randomized, controlled trials comparing robotic with open or laparoscopic sacrocolpopexy, however, there are several publications reporting both retrospective and prospective series of women undergoing robotic-assisted sacrocolpopexy.
Robotic-assisted pelvic floor surgery has become an important component of the pelvic surgeon's armamentarium in the treatment of symptomatic POP. Those pelvic surgeons without significant expertise in laparoscopy required for sacral dissection and intracorporeal suturing can readily learn the necessary techniques required for robotic surgery.
泌尿外科、妇科和泌尿妇科领域的盆底重建外科医生不断采用新的技术来修复盆腔器官脱垂（POP），以改善解剖和主观结果。在过去的 5 年中，机器人手术在泌尿外科肿瘤学、妇科肿瘤学、心胸外科领域得到了广泛应用，现在也应用于女性盆底医学领域。机器人手术已成为 POP 治疗手段之一，使盆底外科医生能够将经腹骶骨阴道固定术这一“金标准”技术微创化，术中发病率降低，恢复期缩短。本文旨在讨论机器人脱垂修复技术以及发病率、成本和临床结果。
微创方法治疗 POP 的最初尝试是腹腔镜手术，但只有那些具有丰富腹腔镜技能的外科医生才能完成。机器人技术的应用使得大多数盆底外科医生更容易从开放或腹腔镜手术转为机器人手术。目前还没有发表比较机器人与开腹或腹腔镜骶骨阴道固定术的随机对照试验，但有几项出版物报告了接受机器人辅助骶骨阴道固定术的女性的回顾性和前瞻性系列研究。
机器人辅助盆底手术已成为治疗有症状的 POP 的盆底外科医生手术器械的重要组成部分。那些没有进行骶骨解剖和体内缝合等腹腔镜手术所需专业知识的盆底外科医生可以很容易地学习机器人手术所需的必要技术。
