Ferrigni Erin, Oh Sumin, Butler Kristina, Cornella Jeffrey L, Khan Aqsa, Wolter Christopher E, Yi Johnny
Department of Medical and Surgical Gynecology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
Department of Obstetrics and Gynecology, Korea University Guro Hospital, Seoul, Korea.
Int Urogynecol J. 2025 Jun 20. doi: 10.1007/s00192-025-06204-z.
To evaluate the feasibility and perioperative outcomes of single-port robotic (RSP) sacrocolpopexy (SCP) in comparison to the multi-port approach (RMP).
This was a retrospective cohort study set at an academic, tertiary care center. The primary outcome was operative time (incision to closure) and the secondary outcomes included number and severity of complications. Medical charts were reviewed of patients who had undergone a robotic SCP between March 2018 and December 2024. Differences were tested using Mann-Whitney U tests, Fisher's exact tests, and multivariable regression models.
One hundred and eighty-one eligible cases were included. Among them, 109 patients underwent RMP, and 72 patients underwent the RSP approach. For operative time, RSP SCP was statistically significantly shorter than RMP SCP by 40 min (216 versus 176 min, p < .001). The hospital length of stay was shorter for the RSP group (11.0 versus 17.0 h, p < .001), while EBL showed no difference between groups (p = 0.18). No conversion to laparoscopy or laparotomy was found in both groups. Number and severity of adverse events assessed by Clavien-Dindo classification were similar and overall complication rates and complications requiring surgical correction under anesthesia did not show a difference (Clavien-Dindo Grade III, RMP 11.0% vs RSP 5.6%, p = 0.58). Median follow-up was 15.2 weeks postoperatively, and there were no significant differences in reoperation within 30 days, mesh erosion, prolapse recurrence and subsequent reoperations due to the recurrence.
Single-port robotic sacrocolpopexy is a safe and feasible minimally invasive technique to address apical pelvic floor prolapse.
为评估单孔机器人辅助(RSP)骶骨阴道固定术(SCP)与多孔方法(RMP)相比的可行性及围手术期结局。
这是一项在学术性三级医疗中心开展的回顾性队列研究。主要结局为手术时间(切开至缝合),次要结局包括并发症的数量及严重程度。对2018年3月至2024年12月期间接受机器人辅助SCP的患者病历进行回顾。使用曼-惠特尼U检验、费舍尔精确检验和多变量回归模型进行差异检验。
纳入181例符合条件的病例。其中,109例患者接受RMP,72例患者接受RSP方法。对于手术时间,RSP SCP在统计学上显著短于RMP SCP,短40分钟(216分钟对176分钟,p<0.001)。RSP组的住院时间更短(11.0小时对17.0小时,p<0.001),而两组间估计失血量(EBL)无差异(p = 0.18)。两组均未发现转为腹腔镜手术或开腹手术的情况。根据Clavien-Dindo分类评估的不良事件数量及严重程度相似,总体并发症发生率和麻醉下需要手术矫正的并发症发生率无差异(Clavien-Dindo III级,RMP为11.0%,RSP为5.6%,p = 0.58)。术后中位随访时间为15.2周,30天内再次手术、网片侵蚀、脱垂复发及因复发导致的后续再次手术方面均无显著差异。
单孔机器人辅助骶骨阴道固定术是治疗盆腔顶脱垂的一种安全可行的微创技术。