Robot-Assisted Sacrocolpopexy Surgery

Sacrocolpopexy

Pelvic organ prolapse is a common gynaecology condition among menopausal women, and a significant number eventually require surgical treatment to manage its symptoms and improve quality of life. Sacrocolpopexy has emerged as the gold-standard treatment for this condition, particularly for addressing apical compartment prolapse. 

Various approaches can be used for the procedure, including robot-assisted sacrocolpopexy and robot-assisted sacrocolpopexy, each offering specific advantages for suitable candidates. This comprehensive guide explores everything patients need to know about sacrocolpopexy surgery, from preparation and procedure steps to recovery and expected outcomes. 

Why CARE Group Hospitals is Your Top Choice for Sacrocolpopexy Surgery in Hyderabad

CARE Group Hospitals is the premier destination for sacrocolpopexy surgery in Hyderabad, offering exceptional expertise in this crucial procedure. 

The hospital features a Centre of Excellence for OB-GYN Surgeries with a state-of-the-art HD Laparoscopy unit and advanced robotic systems that enable surgeons to perform minimally invasive procedures with remarkable precision. This advanced technology is particularly beneficial for sacrocolpopexy, which requires detailed visualisation and careful mesh placement.

The hospital's urogynaecology department excels at addressing pelvic floor issues, making it perfectly equipped to handle sacrocolpopexy procedures. The hospital maintains the highest care, safety, and hygiene standards, underscoring CARE Hospitals' commitment to excellence in all aspects of patient care.

Cutting-edge Surgical Innovations at CARE Hospitals

Modern sacrocolpopexy at CARE Hospitals employs minimally invasive approaches that have largely replaced traditional open surgeries. Laparoscopic sacrocolpopexy, which emerged in the 1990s, offers significant advantages, including faster recovery, reduced complications, and better cosmetic results. This approach preserves the vaginal axis and length while achieving excellent anatomical correction.

The most significant technological advancement at CARE Hospitals is the robot-assisted sacrocolpopexy system. The da Vinci Surgical System provides surgeons with remarkable capabilities:

• Three-dimensional vision with enhanced magnification for precise tissue identification
• Wristed instruments with seven degrees of freedom for improved manoeuvrability
• Physiologic tremor filtering for steadier movements during delicate procedures
• Advanced suturing capabilities for secure mesh attachment

These technological innovations address the limitations of conventional laparoscopy, mainly the steep learning curve that traditionally restricted the widespread adoption of minimally invasive approaches. 

At CARE Hospitals, surgeons can tailor the sacrocolpopexy procedure to each patient's specific anatomical needs. 

Conditions for Sacrocolpopexy

The primary indication for this procedure is when pelvic organs begin slipping into the vagina. This occurs because the pelvic floor muscles and ligaments that usually hold these organs in place become stretched, weakened, or torn over time, causing organs to slip from their normal positions.

Depending on which organs are involved, different types of prolapse may require sacrocolpopexy:

• Apical (vaginal vault) prolapse
• Uterine prolapse
• Cervical prolapse
• Combined prolapse of multiple pelvic organs
• Increased abdominal pressure from chronic constipation or coughing
• Genetic predisposition to weaker pelvic muscles

Types of Sacrocolpopexy Procedures

Surgeons perform sacrocolpopexy using three distinct approaches, each with its specific techniques and advantages. 

• Abdominal (Open) Sacrocolpopexy: Abdominal sacrocolpopexy has traditionally been considered the gold standard for treating apical vaginal prolapse. This approach involves making a larger incision in the abdomen to access the pelvic area. Surgeons attach mesh from the vagina to the sacral promontory, creating support that mimics natural ligaments. 
• Laparoscopic Sacrocolpopexy: Laparoscopic sacrocolpopexy emerged as a popular alternative to open surgery. This minimally invasive technique utilises small incisions and a camera to perform the same procedure. Most surgeons now prefer this approach due to its advantages.
• Robot-assisted Sacrocolpopexy: Robot-assisted Sacrocolpopexy follows similar steps to laparoscopic sacrocolpopexy but utilises robotic controllers passed through small incisions. The robotic system offers surgeons enhanced capabilities, including multiple degrees of freedom for improved dexterity and elimination of hand tremors.

For patients with uterovaginal prolapse, surgeons often perform a concomitant hysterectomy alongside sacrocolpopexy. 

Know the Procedure

Knowing each step, from initial preparation through the advanced surgical procedure to your recovery period, empowers you as a patient.

Pre-surgery Preparation

Thorough preparation is vital for successful sacrocolpopexy outcomes. Patients scheduled for this procedure undergo a comprehensive preoperative assessment that helps surgeons plan effectively and identify potential complications.

Before surgery, patients receive specific instructions from their doctors, including:

• No eating & drinking after midnight the night before surgery
• Taking only approved medications with water
• Clear liquids permitted until 2-3 hours before surgery

Sacrocolpopexy surgery Procedure

The sacrocolpopexy procedure follows a precise sequence of surgical steps designed to restore proper organ positioning. After general anaesthesia induction, the surgical team positions the patient in a modified low lithotomy position.

For standard laparoscopic sacrocolpopexy, the surgeon makes four to five small incisions in the abdomen, creating access points for surgical instruments.  The surgeon then inflates the abdomen with carbon dioxide gas to make a working space for the procedure.

Next, the surgeon inserts a laparoscope (a thin tube with a camera) and other unique surgical instruments and carefully separates the bladder from the anterior vagina along the vesicovaginal septum. This dissection continues posteriorly to separate the vagina from the rectum along the rectovaginal septum. The surgeon places surgical mesh at both the top and bottom walls of the vagina.

Finally, the surgeon inspects the bladder and closes the incisions using either glue or tape. The fundamental steps for robot-assisted sacrocolpopexy surgery remain similar, yet robotic controllers pass through the incisions, offering enhanced precision. This procedure typically takes two to four hours, and the robotic assistance enables precise movements throughout.

Post-surgery Recovery

Recovery after sacrocolpopexy requires patience and adherence to specific guidelines. During this period, patients typically have a catheter from their bladder and possibly a drain from the surgical incision.

Upon discharge, patients should understand that recovery happens in stages. Most women notice improvement within the first week following surgery, yet complete internal healing takes six to eight weeks. 

Activity restrictions are critically important during recovery:

• Avoid lifting, pulling, or pushing anything heavier than 5-10 pounds for 6-8 weeks
• Refrain from strenuous exercise during this period
• Avoid sexual intercourse and tampon use for 8 weeks
• Steer clear of vacuuming, pushing heavy doors, or grocery carts
• Do not swim or soak in water for 4-6 weeks
• For pain management, take ibuprofen every six hours during the first 24 hours, alongside prescribed pain medication as directed. 

Risks and Complications

Sacrocolpopexy surgery carries specific risks, such as:

• Damage to presacral vessels can cause significant bleeding that may become life-threatening. 
• Mesh-related issues, such as complete mesh extrusion into organ cavities, mesh infection, or mesh exposure through vaginal or rectal walls
• Damage to nearby vital organs, such as the bladder, rectum, and intestines 
• Ureteral injuries
• Urinary issues include difficulty emptying the bladder completely
• Bowel problems range from temporary ileus to more persistent constipation.

After surgery, patients should contact their doctor immediately if experiencing: 

• Fever over 100°F (37.8°C)
• Heavy vaginal bleeding
• Urinary retention

Benefits of Sacrocolpopexy Surgery

Patients undergoing sacrocolpopexy surgery experience remarkably positive outcomes:

• High success rates
• Improvement in the quality of life 
• Relief from prolapse symptoms 
• Sexual dysfunction improvement
• Constipation relief
• Voiding dysfunction reduction
• Stress urinary incontinence improvement
• POP symptoms relief

Robot-assisted sacrocolpopexy delivers additional advantages. This minimally invasive procedure results in less blood loss, shorter hospital stays, & faster recovery times compared to traditional methods. 

Insurance Assistance for Sacrocolpopexy Surgery

Understanding the financial aspects of sacrocolpopexy surgery can often feel overwhelming. Sacrocolpopexy qualifies as a medically necessary treatment for properly diagnosed pelvic organ prolapse. At CARE Hospitals, our dedicated team will help you navigate the insurance claim for this procedure.

Second Opinion for Sacrocolpopexy Surgery

Contemplating sacrocolpopexy surgery deserves careful consideration, as deciding on the right treatment approach impacts long-term quality of life. Seeking a second opinion helps patients confirm diagnosis accuracy and explore all available treatment options before committing to surgery.

Seeking additional medical advice becomes particularly valuable in these situations:

• When your diagnosis seems unclear, or your symptoms don't align with the proposed treatment
• For complex conditions like pelvic organ prolapse requiring specialised expertise
• When facing multiple treatment options, including different approaches to sacrocolpopexy
• Before making major medical decisions about surgical intervention
• When you need personalised treatment recommendations based on your specific circumstances

Conclusion

Sacrocolpopexy stands as the most effective surgical solution for pelvic organ prolapse, delivering excellent success rates. The procedure's remarkable outcomes stem from continuous technological advancements and refined surgical techniques at specialised centres like CARE Hospitals.

CARE Hospitals combines expert surgical teams with state-of-the-art technology to achieve optimal results. Their specialists excel in all approaches - traditional, laparoscopic, and robot-assisted procedures - allowing tailored treatment plans for each patient's specific needs.