Patient Selection, Risks, and Alternative Surgical Strategies

Sacrocolpopexy is an abdominal surgical procedure to correct prolapse of the vaginal apex. The operation is designed to restore the vagina to its normal anatomic position and function by re-suspending the vaginal apex to the anterior longitudinal ligament overlying the sacrum using graft material. Although there is no specific published data on the topic, there are certain factors that may determine who the optimal candidate is for robotic-assisted sacrocolpopexy (RASC). Before choosing RASC, it is important to consider the other options available for apical support which vary from vaginal approaches to abdominal approaches and from open abdominal procedures to minimally invasive surgeries. Furthermore, patient selection should take into consideration advantages and challenges of robotic surgery along with specific patient criteria such as baseline health, cardiovascular status, body mass index (BMI), and requirement for prolonged steep Trendelenburg and dorsal lithotomy patient position.