Presentation Authors: Carrie Stewart*, Ariel Moradzadeh, Beth Moore, Jennifer Anger, Karyn Eilber, Beverly HIlls, CA
Introduction: We describe the surgical steps for performing laparoscopic robotic assisted sacrocolporectocpexy in a patient with multicompartment pelvic organ prolapse.
Methods: A 71-year-old gravida 4 para 1 woman with vaginal pressure and constipation reported splinting to facilitate bowel movements. She had a prior hysterectomy for benign disease. Her pelvic organ prolapse quantification examination demonstrated stage II vaginal vault prolapse. A dynamic MRI demonstrated rectocele, cystocele and apical vault prolapse.
Results: The patient underwent rectopexy and vaginal vault suspension under the care of the colorectal and urologic surgery teams. Major steps included the following: 1) Sigmoid reflection and exposure of the rectovaginal space 2) Allograft attachment to the rectal serosa 3) Anterior longitudinal ligament exposure 4) Vesicovaginal space dissection 5) Attachment of allograft the posterior vagina 6) Attachment of allograft to the anterior vagina 6) Securing allograft to the anterior longitudinal ligament.
Conclusions: Robotic sacrocolpopexy with concurrent rectopexy is a treatment option for multicompartment pelvic organ prolapse performed in multidisciplinary manner with the assistance of a colorectal surgeon.