Giovanni Panico(a), Giuseppe Campagna(a), Lorenzo Vacca(a), Daniela Caramazza(a), Giovanni
Scambia(b,c), Alfredo Ercoli(c)
a) Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Uroginecologia e Chirurgia
Ricostruttiva del Pavimento Pelvico, Dipartimento di Scienze della Salute della Donna e del
Bambino e di Sanità Pubblica, Roma, Italia
b) Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Ginecologia Oncologica,
Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica,
Roma, Italia
c) Università Cattolica del Sacro Cuore, Istituto di Ginecologia ed Ostetricia, Roma,
Italia
d) PID Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva, Università degli studi
di Messina, Policlinico G.Martino, Messina, Italia
Introduction
Over the last decades the introduction of the robotic surgery produced great improvements in terms
of learning curve and feasibility of minimally invasive surgery. The aim of this study was to
evaluate the feasibility, efficacy, and safeness of nerve-sparing laparoscopic sacralcolpopexy (SCP)
performed with a minimally invasive approach by using 2.9-mm Senhance TM surgical robotic
system (Senhance, TRANSENTERIX Inc., USA).
Methods
A 60-year-old Caucasian woman (body mass index 28.7 kg/m2), gravida 2, para 2 with
symptomatic POP-Q (Aa: 2, Ba: 3, C: +4, Bp:2, Ap: 2, TVL:10) underwent subtotal hysterectomy
with bilateral salpingo-oophorectomy with nerve-sparing (Fig 1) sacral colpopexy performed with
Senhance surgical robotic system (details of instrument Fig.2; position of trocar Fig.3) in our
Urogynecological Department of Fondazione Policlinico A. Gemelli, Rome, Italy.
Results
Total operative time was 186 min while docking time was 9 min. The estimated blood loss was 30
mL. No complications were noted according to Clavien-Dindo classification. The patient was
discharged home on postoperative day 2. The urogynecological physical examination at the day of
the discharge and at the 3 months follow up showed the surgical anatomic success (<2 POP-Q
stage). Symptoms of prolapse, such as vaginal bulging and discomfort during sexual intercourse,
had disappeared completely. The patient was fully satisfied with the cosmetic result.
Conclusions
This is the first case of SCP performed with this innovative system. SCP performed using
“Senhance” is a feasible and effective approach with good results in terms of operative time,
cosmesis, postoperative pain and length of hospitalization. Further studies are needed to better
define the advantages and costs of this innovative technique.