No Difference in Prolapse Recurrence Rates Between Laparoscopic and Robotic-Assisted Sacrocolpopexy: A Long-Term Comparison

Objective: To compare the long-term efficacy of conventional laparoscopic sacrocolpopexy with those of robot-assisted laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse.

Design: Retrospective cohort study.

Setting: Tertiary referral center in China.

Patients: A total of 139 patients -74 having laparoscopic and 65 robotic-assisted sacrocolpopexy between January 2015 and December 2021 were included.

Interventions: Either laparoscopic or robotic-assisted sacrocolpopexy.

Measurements and main results: The median follow-up times of the laparoscopic group and robotic-assisted group were 60 (interquartile range 39-91) and 46 (interquartile range 38-73) months, respectively. Compared with laparoscopy, the robotic-assisted group had a shorter operative time (164 ± 37 minutes vs 186 ± 36 minutes; p = .001) with no clinically meaningful blood loss between the groups (76 ± 32.1 mL vs 87.6 ± 33 mL). Mesh exposure occurred in 3 patients (4.1%) in the laparoscopic and 2 patients (3.1%) in the robotic-assisted group. The composite success rate did not significantly differ between laparoscopic and robotic-assisted groups (89.2% vs 90.8%, p = .757). Kaplan-Meier survival analysis also revealed no significant differences in the overall rates of recurrent pelvic organ prolapse between the two groups (p = .915).

Conclusion: There is no difference in the rates of prolapse recurrence or mesh exposure at nearly 4 years between laparoscopic or robotic-assisted sacrocolpopexy. There was an average 20-minute time saving for robotic-assisted procedures, with no clinically important difference in blood loss between the surgical approaches.