BACKGROUND AND PURPOSE: 

• Robotic-assisted sacrocolpopexy is criticized for high and potentially avoidable cost 
• There is evidence that dedicated robotic teams can improve operating room efficiency in general surgery, urological, and colorectal surgery literature 
• Carter-Brooks et al. (Female Pelvic Medicine & Reconstructive Surgery, 2018) investigated whether a determined and dedicated robotic team can significantly reduce operative time, and therefore cost 

METHODS: 

• Retrospective cohort study  
• Inclusion: All robotic-assisted sacrocolpopexy performed by a single surgeon at two different institutions 
  • One institution had a dedicated robotic team, while the other did not 
• Differences were assessed using the chi-squared and t tests  
• Multivariable linear regression identified confounders that may impact operative time 
• Primary objective  
  • Impact of dedicated robotic team during robotic-assisted sacrocolpopexy (RASC) on operative time  
• Secondary objective  
  • Impact of dedicated robotic team during RASC for other surgical outcomes, specifically perioperative complications and pelvic organ prolapse (POP) recurrence rates 

RESULTS: 

• 88 cases were analyzed  
• Cohort constitution 
  • White 92.8% | Postmenopausal 85.5% | Stage III prolapse 71.1% | Mean age 60.6 | Mean BMI 28.5 kg/m2  
• 19.3% of cases were performed by a dedicated robotic team 
• Mean operative time for cases with vs without a dedicated robotics team  
  •  131.8 vs 160.2 minutes  
    • 17.7% decrease (P < 0.001) 
• Significance persisted following multivariable regression and adjusting for case order and prior to or after hysterectomy 
• Operative complications for cases with and without a dedicated robotic team did not differ between groups  
  • 0% vs 2.9%, P = 0.50  
• POP recurrence for cases with and without dedicated robotic team did not differ between groups 
  • 0% vs 7.5%, P = 0.29 

CONCLUSION:  

• A dedicated robotic team for RASC is efficient, reducing mean operative team by almost a half hour 
• Even without cost analysis, the authors state that the time reduction can be used to advocate for dedicated robotic teams for RASC procedures  

 Learn More – Primary Sources: 

The Impact of a Dedicated Robotic Team on Robotic-Assisted Sacrocolpopexy Outcomes 

Related ObG Topics:

Prolapse and Stress Incontinence: Burch Procedure vs Midurethral Sling

What is the Best Approach to Repair Vaginal Vault Prolapse following Hysterectomy?

Restricted vs. Liberal Activity Following Reconstructive Pelvic Surgery