Comparison of surgical outcomes between robotic and laparoscopic sacrocolpopexy with concomitant total hysterectomy for pelvic organ prolapse: A retrospective cohort study.

Abstract

<h4>Aim</h4>This study aimed to compare short- and long-term surgical outcomes between robotic sacrocolpopexy (RSC) and laparoscopic sacrocolpopexy (LSC), performed with concomitant total hysterectomy, in patients with symptomatic pelvic organ prolapse (POP).<h4>Methods</h4>This retrospective cohort study included 167 women who underwent RSC (n = 113) or LSC (n = 54) with hysterectomy for uterine prolapse at Kawasaki Medical University between March 2020 and December 2024. Perioperative parameters, complications (Clavien-Dindo classification), and POP recurrence were assessed. The POP-Q was used for anatomical evaluation. Long-term outcomes such as recurrence, urinary incontinence, and mesh erosion were monitored over a median follow-up of 30 (RSC) and 52.5 (LSC) months.<h4>Results</h4>The patients in the RSC group were significantly younger and had a higher incidence of diabetes. RSC had longer operative times (median 175 min vs. 152 min; p < 0.01) but comparable blood loss, complication rates, and hospital stay. POP-Q showed greater cervical elevation in the RSC group at one month (p < 0.05). The long-term recurrence rate was low and similar between the groups (RSC, 2.7%; LSC, 3.7%; p = 0.71). Mesh erosion, urinary incontinence, and organ prolapse were rare and did not differ significantly between the groups.<h4>Conclusions</h4>RSC with concomitant hysterectomy is a safe and effective alternative to LSC with comparable short- and long-term outcomes. Despite longer operative times, RSC offers anatomical benefits without increasing the risk of postoperative complications or recurrence.