8777 Descriptive Postoperative Complications Following Robotic Sacrocolpoperineopexy in 1000+ Patients
Shu MKM, Kadakia D, Andres S, Nassar DT, and Eddib A. 8777 Descriptive Postoperative Complications Following Robotic Sacrocolpoperineopexy in 1000+ Patients. J Minim Invasive Gynecol 2022; 29(11):S147-S148.
J Minim Invasive Gynecol
Study Objective: Sacrocolpoperineopexy (SCPP) repairs multicompartmental pelvic organ prolapse (POP) and involves extensive dissection along the anterior and posterior vaginal length to a greater degree than sacrocolpopexy. Medical literature is lacking large-scale studies of the complication profile for SCPP. This study aims to offer a descriptive investigation of the intraoperative and postoperative complications amongst over 1000 cases of SCPP.
Design: Descriptive study.
Setting: Academic-affiliated community hospital.
Patients or Participants: All patients (n=1243) undergoing a robotic-assisted SCPP by a single urogynecologist between January 2012 and March 2022 were included in this study.
Interventions: Of all patients, 821 (66%) underwent a concomitant hysterectomy: 62% supracervical, 4.1% total, and 34% with prior hysterectomy and vaginal vault suspension. 1117 (90.2%) were performed without co-surgeons ie. sling placement by a urologist or hysterectomy by a gynecologist. 1145 (92.1%) had a concomitant anti-incontinence procedure, with 91.2% being a transobturator sling.
Measurements and Main Results: The median age of all patients was 66 years old, with an average BMI of 28.2 kg/m2. Rate of intraoperative complication was 1.4% (n=15); blood transfusion (0.1%, n=1), and bladder (1%, n=11), ureteral (0%), or bowel injury (0.3%, n=3). 35.8% (n=371) required discharge with home catheterization. 5.7% (n=61) of all patients had a return to the emergency department (ED) within 90 days of surgery mainly for pain (n=15), nausea and vomiting (n=3), constipation (n=8), or urinary tract symptoms (n=18). 2.7% (n=29) required readmission, and of those, 17.2% (n=5) required re-operation if readmitted to the hospital: incisional hernia repair (n=2), drainage of abscess (n=2), and pulmonary embolism thrombectomy (n=1).
Conclusion: SCPP is a treatment for advanced POP that has low rates of intraoperative complications and generally uncomplicated postoperative recovery. This case series of over 1000 procedures demonstrates the safety of the surgery and low rates of postoperative ED visits and hospital readmission on a large scale.