1 Department of Urology, Indiana University School of Medicine , Indianapolis, Indiana.
2 Department of Obstetrics and Gynecology, St. Vincent Health , Indianapolis, Indiana.
J Endourol. 2018 May;32(S1):S111-S116. doi: 10.1089/end.2018.0054.
Robot-assisted sacral colpopexy (RASC) is a fast growing approach for surgeons treating patients with advanced stage pelvic organ prolapse (POP). Open abdominal sacral colpopexy has been the gold standard for advanced POP but requires longer hospital stays and a much larger incision. The indications, preoperative preparation, operative positioning, and operative steps are detailed, and an accompanying video shows the approach.
RASC can be broken down into 11 steps and the reader will be able to reference the article to the corresponding portion of the video.
A total of 119 women underwent RASC between 2009 and 2016. Patients had similar preoperative characteristics. All POP-Q, UDI-6, and quality of life scores improved postoperatively. Apical failure was noted in 0, anterior failure was noted in 7 (average Ba +1.1 cm in failures), and posterior failure was noted in 4 (mean Bp +1.0 cm) patients at 15.6 months' follow-up. A total of 11 suture erosions were noted in five patients requiring excision in the clinic and 2 patients in the operating room. Four suture erosions were managed with observation. Two mesh exposure events were noted.
Outcomes for robotic sacral colpopexy are like those of open abdominal sacral colpopexy.
机器人辅助经阴道骶骨固定术（RASC）是一种治疗晚期盆腔器官脱垂（POP）患者的快速发展的方法。开放式经腹骶骨固定术一直是治疗晚期 POP 的金标准，但需要更长的住院时间和更大的切口。详细介绍了适应证、术前准备、手术体位和手术步骤，并附有视频展示。
RASC 可以分为 11 个步骤，读者可以参考文章找到相应的视频部分。
2009 年至 2016 年间，共有 119 名女性接受了 RASC。患者具有相似的术前特征。所有 POP-Q、UDI-6 和生活质量评分均在术后得到改善。在 15.6 个月的随访中，有 0 名患者出现穹窿顶失败，7 名患者（失败时平均 Ba+1.1cm）出现前壁失败，4 名患者（失败时平均 Bp+1.0cm）出现后壁失败。共有 11 名患者出现 5 例缝线侵蚀，需要在诊所切除，2 例在手术室切除。4 例缝线侵蚀采用观察治疗。有 2 例出现网片暴露事件。
机器人骶骨固定术的结果与开放式经腹骶骨固定术相似。
