Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial.
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OBJECTIVE: To compare conventional laparoscopic and robotic-assisted laparoscopic sacrocolpopexy for vaginal apex prolapse. METHODS: This single-center, blinded randomized trial included participants with stage 2-4 posthysterectomy vaginal prolapse. Participants were randomized to laparoscopic or robotic sacrocolpopexy. The primary outcome was total operative time from incision to closure. Secondary outcomes were postoperative pain, functional activity, bowel and bladder symptoms, quality of life, anatomic vaginal support, and cost from a health care system perspective. RESULTS: A total of 78 patients enrolled and were randomized (laparoscopic n=38; robotic n=40). Total operative time was significantly longer in the robotic group compared with the laparoscopic group (+67-minute difference; 95% confidence interval [CI] 43-89; P<.001). Anesthesia time, total time in the operating room, total sacrocolpopexy time, and total suturing time were all significantly longer in the robotic group. Participants in the robotic group also had significantly higher pain at rest and with activity during weeks 3 through 5 after surgery and required longer use of nonsteroidal anti-inflammatory drugs (median, 20 compared with 11 days, P<.005). The robotic group incurred greater cost than the laparoscopic group (mean difference +$1,936; 95% CI $417-$3,454; P=.008). Both groups demonstrated significant improvement in vaginal support and functional outcomes 1 year after surgery with no differences between groups. CONCLUSION: Robotic-assisted sacrocolpopexy results in longer operating time and increased pain and cost compared with the conventional laparoscopic approach.
Published Version (Please cite this version)10.1097/AOG.0b013e318231537c
Publication InfoBarber, Matthew Don; Chen, C; Frick, A; Jelovsek, John E; & Paraiso, Marie Fidela R (2011). Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol, 118(5). pp. 1005-1013. 10.1097/AOG.0b013e318231537c. Retrieved from http://hdl.handle.net/10161/15392.
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Edwin Crowell Hamblen Professor of Reproductive Biology and Family Planning
Associate Professor of Obstetrics and Gynecology
Dr. Jelovsek is the Vice Chair of Education and the Director of Data Science for Women’s Health in Department of Obstetrics & Gynecology (OBGYN) at Duke University. He is Board Certified in OBGYN by the American Board of OBGYN and Board Certified in Female Pelvic Medicine & Reconstructive Surgery by the American Board of OBGYN and American Board of Urology. He currently practices Female Pelvic Medicine and Reconstructive Surgery (FPMRS). He has expertise in the development and v
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