Robot-Assisted Laparoscopy Repairs Vaginal Prolapse

A new study has found that laparoscopic surgery assisted by a surgical robot to fix vaginal vault prolapse is an effective option to traditional open surgical repair.

Researchers from the Mayo Clinic (Rochester, MN, USA) followed 30 patients undergoing robotic-assisted laparoscopic repair for post-hysterectomy vaginal vault prolapse. The technique involves a robot to speed up the process and to simplify its technically difficult aspects, such as the wrist strain involved in tying a large number of knots. The investigators analyzed the results of the surgery for 21 of the women who were 12 or more months post-surgery. The average follow-up time for the patients involved was 24 months, with a range of 12 to 26 months post-surgery.

The average age was 67, with an age range of 47 to 83, and average time in surgery was 3.1 hours. One patient experienced recurrence of her vaginal vault prolapse, and another developed a recurrent grade 3 rectocele, in which the rectum protrudes into the vagina. All patients indicated they were satisfied with the outcomes of their surgeries. The study was published in the August 2006 issue of the Journal of Urology.

The new laparoscopic surgery has advantages over traditional open sacrocolpopexy, including less overall recovery time, a shorter hospital stay, potentially lower risk of post-surgery bleeding, and markedly less pain. Women who may not tolerate the open procedure due to health issues may be candidates for this surgery.

"After hysterectomy, there's a lack of support for the vagina as you remove the ligaments, and the vagina can fall down,” said Daniel Elliott, M.D., Mayo Clinic urologist and lead study investigator. "To imagine this, it helps to think of the vagina like a tube sock that's inverted out. For some women, the vagina can come completely out--like three to five inches. This problem can be devastating both physically and socially. Sometimes the patients can hardly walk.”



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