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
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).
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.
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.
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.