The robotic platform allows the surgeon to control a 3D camera and 3 robotic arms that are introduced through small incisions in the abdomen. An assistant is also at the patient’s bedside throughout the procedure to assist the surgeon through a separate small incision.
During the sacrocolpopexy procedure, a single piece of polypropylene mesh is used. The piece of mesh is cut into two identical strips that are tailored to the patient’s prolapse. One mesh segment is sutured into the space between the bladder and the vagina and the second mesh segment is sutured into the space between the rectum and the vagina. The mesh is also attached to the top of the vagina or cervix. The other ends of the mesh segments are sutured to the sacrum. This elevates the entire vagina, correcting the cystocele, rectocele, and enterocele.
In patients with perineal descent, sacrocolpoperineopexy is performed in order to elevate the pelvic floor.
As mentioned above, mesh placed during the sacrocolpopexy procedure is attached to the sacrum or lower backbone through the abdomen and is therefore not considered transvaginal mesh as it relates to the FDA communication on the safety and effectiveness of transvaginal placement of surgical mesh.
Dr. Shashoua has been performing open abdominal sacrocolpopexy since 1995 and da Vinci sacrocolpopexy since 2007. Most sacrocolpopexy surgeries are now performed with the da Vinci robot. Dr. Shashoua performs well over 100 sacrocolpopexy procedures a year.
Success rate is over 90%. Overall complication rate is less than 5%, and most complications are successfully managed non-surgically.
Patients typically are discharged from the hospital on the day following the procedure and return to normal activity in 2-3 weeks. Healing is for the most part complete 6 weeks after surgery. At no time should mesh be felt in the vagina.
Listen to Dr. Shashoua narrate a video of sacrocolpoperineopexy and partial hysterectomy for pelvic organ prolapse. da Vinci sacrocolpoperineopexy with supracervical hysterectomy.
Listen to Dr. Shashoua narrate a video of sacrocolpoperineopexy for pelvic organ prolapse in a patient who has already had a hysterectomy. da Vinci sacrocolpoperineopexy in a patient who has already had a hysterectomy.
Watch Dr. Shashoua perform da Vinci sacrocolpoperineopexy while leaving the uterus in place: da Vinci Sacrocolpoperineopexy Procedure: Pelvic Organ Prolapse Repair Leaving Uterus in Place.
Disclaimer: Due to the graphic nature of the video, it may not be suitable for all viewers.