Robotic Approach to Pelvic Floor Disorders
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MULTIDISCIPLINARY APPROACH TO PELVIC FLOOR DISORDERS (A HALVERSON, SECTION EDITOR)
Robotic Approach to Pelvic Floor Disorders Nathan Kow • Marie Fidela R. Paraiso
Published online: 12 March 2013 Springer Science + Business Media New York 2013
Abstract Pelvic floor disorders (PFDs) affect a significant number of women during their lifetime with approximately 11 % of all women seeking surgical intervention for PFDs. Women seeking surgical intervention for PFDs have a variety of procedures, many of which can be performed using a minimally invasive approach. Among the array of options, utilization of the robotic platform continues to garner more interest from both patients and surgeons. Initial studies have shown the safety and feasibility of procedures adapted for the robotic platform. Newer studies have begun to investigate the long-term efficacy and functional outcomes of roboticassisted surgery. Other investigations demonstrate varying cost differences between robotic pelvic floor procedures compared to laparotomy and conventional laparoscopy procedures. An attractive aspect of the robotic platform is a significantly shorter learning curve for surgeons compared with the prolonged learning curve for conventional laparoscopy. As surgeons decide whether they will ultimately adopt this surgical modality, it is imperative that level 1 evidence and other well designed studies be available for surgeons to assess the robotic platform objectively. Keywords Robotic surgery Pelvic floor disorders Pelvic organ prolapse Incontinence Rectal prolapse Introduction Approximately 11 % of women in the United States will require surgical intervention for pelvic floor disorders (PFDs) N. Kow (&) M. F. R. Paraiso Center of Urogynecology and Pelvic Floor Disorders, Obstetrics, Gynecology & Women’s Health Institute, Desk A-81, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA e-mail: [email protected]
[1]. As the population ages, it is estimated that by 2050, over 50 million women will have at least one pelvic floor disorder [2]. Traditional vaginal and abdominal procedures to correct pelvic floor disorders are increasingly being replaced by alternative minimally invasive approaches in order to decrease morbidity associated with open surgery. The conventional laparoscopic approach to correcting pelvic floor disorders provides many clinical advantages compared with open abdominal surgery. However, a lengthy learning curve associated with the advanced skill set required to perform reconstructive procedures has limited the adoption of this technique. Recently, the development of robotic platforms in assisting with complex minimally invasive procedures has become widely adopted as an alternative minimally invasive approach to conventional laparoscopy. The daVinci surgical system (Intuitive Surgical, Inc., Sunnyvale, CA, USA) was approved by the Food and Drug Administration in 2005 and its use in many surgical fields has grown considerably over the past several years. A recent retrospective study suggests that the introdu
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