Pelvic organ prolapsus (POP) is a common issue and health problem among elderly women. POP involves the displacement of pelvic organs as bladder, uterus, cervical cuff, rectum or even sometimes small intestines descending in to vagina. Nearly 20% of women with POP undergo surgical intervention during their lives (1). POP can significantly impact women’s lives with symptoms of a protruding vaginal mass, pelvic pressure, dyspareunia, and low back pain(2). Abdominal sacrocolpopexy (ACS) is a safe and effective surgical intervention which has higher cure and lower recurrence rates as compared with vaginal approach. Laparoscopic sacrocolpopexy replaced ACS by years. However, despite a steep learning curve robotic sacrocolpopexy (RSC) offers many advantages as deep pelvic dissection, 3D vision and multiple intracorporeal suturing(3).

A case series of 10 patients with period of menopause whom undergone RSC performed by a high experienced surgeon is evaluated and video case presentation showed properly the important steps of the robotic sacrocolpopexy. 6 of 10 patients also undergone hysterectomy during the procedures. Patent age, gravid, parity, operation type, operation time (minutes), preoperative/postoperative hemoglobin, morbidity, incontinence, complications and duration of hospitalization were all evaluated. 15 X 4 cm Polypropylene mesh used for fixation of cervical cuff to sacral promontory. Tacker used to fix the mesh to the sacral promontorium. 1/0 Running suture used for closure peritoneum onto the mesh reaching from sacral site to proximal vaginal site. One standard stepwise procedure was selected as video presentation to show important anatomic landmarks and technical properties.

The average age of patients was 63.3 (54-73) while gravidity and parity were 3.3 (1-6) and 2.5 (1-3) respectively. Six patients demonstrated stage 4 and rest of them were stage 3 POP status. As concerned for morbidity 4 patients had hypertension out of 2 of them also had diabetes. The average operation time was 122,5 (100-180) minutes. Preoperative mean hemoglobin and hematocrite values were 12.94 (11.8-14.7) and 39.27 (35.4- 41.0) while postoperative were 11.92 (9.9- 14.3) and 35.2 (34.7-42.0) mg /dl respectively. None of the patients needed a blood transfusion. Two patients had early and late surgical complication including pain and denovo urge incontinence consecutively. The mean hospitalization time was 2 (1-3) days and 2 patients described incontinence during the postoperative 1 year follow up period. None of the patients described any recurrences.

RSC is an effective and safe surgical intervention of treatment of postmenopausal women admitting with servical cuff prolapsus.

Smith F, Holman C, Moorin R, Tsokos N. Lifetime risk of undergoing surgery forpelvic organ prolapse.Obstet Gynecol2010;116:1096 – 1100
Lukman Y. Utero-vaginal prolapse: a rural disability of the young. East Afr Med J 1995;72:2-9.
Al-Otaibi Mozon, Ju Hee Kim, Sa Ra Lee. Obstet Gynecol Sci 2024;67(2):212-217 https://doi.org/10.5468/ogs.23226.