Robot-assisted re-do sacrohysteropexy after anterior abdominal wall hysteropexy
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IUJ VIDEO
Robot-assisted re-do sacrohysteropexy after anterior abdominal wall hysteropexy Riccardo Bertolo 1 & Francesco Maiorino 1 & Filomena Petta 1 & Matteo Vittori 1 & Chiara Cipriani 1 & Laura La Barbera 2 & Bruno Masci 3 & Pierluigi Bove 1,4 Received: 7 July 2020 / Accepted: 27 September 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis We report the case of a 49-year-old woman who came to our institution complaining of bowel constipation and bladder outlet obstruction due to the recurrence of a pelvic prolapse after anterior abdominal wall hysteropexy performed 1 year before. Methods The patient was counseled to undergo robot-assisted re-do sacrohysteropexy performed using the da Vinci Xi surgical system. The step-by-step technique used for the herein reported clinical case of robot-assisted re-do sacrohysteropexy is shown in the accompanying video. Results Operative time was 120 min. There was virtually no blood loss. No intraoperative complications occurred. Use of analgesic drugs was stopped on the 1st postoperative day. The patient was mobilized on postoperative day 2. The catheter was removed on the 3rd postoperative day, and the patient got back to spontaneous micturition with no post-voiding residual. On the same day, the patient was discharged. At 3-month follow-up, the patient was well with neither bowel nor bladder symptoms. Uroflowmetry was normal. Conclusion We demonstrated the feasibility of robot-assisted re-do sacrohysteropexy. In the surgical technique herein reported, we showed how we were able to partially re-use a previously implanted mesh together with a new one to ensure fixation of a multi-compartment pelvic organ prolapse. Keywords Sacrohysteropexy . Urogenital prolapse . Bladder outlet obstruction . Robotics . Surgical technique
Introduction and aim of the video Three-dimensional, high-definition images, miniaturized instruments with the endo-wrist technology and the surgeon’s Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00192-020-04549-1) contains supplementary material. This video is also available to watch on http://link.springer. com/. Please search for this article by the article title or DOI number, and on the article page click on ‘Supplementary Material’. * Riccardo Bertolo [email protected] 1
Department of Urology, San Carlo di Nancy Hospital, Via Aurelia 275, 00165 Rome, Italy
2
Department of Radiology, San Carlo di Nancy Hospital, Rome, Italy
3
Department of General Surgery, San Carlo di Nancy Hospital, Rome, Italy
4
Urology Unit, Department of Surgery, Tor Vergata University of Rome, Rome, Italy
ergonomic position as well as the advantages for training are the main explanations for why robotic surgery is gaining ground in functional urology [1]. A popular indication is the correction of pelvic organ prolapse [2]. Although still looking forward to high-quality comparative studies, the safety and effectiveness role of robot-assisted laparoscopic sacrohysteropex
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