da Vinci® Pelvic Prolapse Surgery

Pelvic prolapse occurs when a pelvic organ, such as your vagina or uterus slips out of its normal position. Surgery to correct this condition is called sacrocolpopexy. During surgery, doctors use surgical mesh to keep your pelvic organ(s) in the correct spot and ease your symptoms.

Pelvic prolapse surgery can be done with open surgery through one large incision (cut). It can also be done with minimally invasive surgery using traditional laparoscopy or da Vinci Surgery.

What is sacrocolpopexy?

Sacrocolpopexy is a procedure to correct prolapse of the vaginal vault (top of the vagina) in women who have had to restore the vagina to its normal position and function. A variation of this surgery called sacrohysteropexy corrects prolapse of the uterus. This operation is performed in a similar way to Sacrocolpopexy.

What happens during surgery?

Sacrocolpopexy is performed either though an abdominal incision or ‘keyholes’ (using a laparoscope or with a surgical robot), under general anesthesia. The vagina is first freed from the bladder at the front and the rectum and the back. A graft made of permanent synthetic mesh is used to cover the front and back surfaces of the vagina. The mesh is then attached to the sacrum (tail bone). The mesh is then covered by a layer of tissue called the peritoneum that lines the abdominal cavity; this prevents the bowel from getting stuck in the mesh. Sacrocolpopexy can be performed at the same time as surgery for incontinence or vaginal repair for bladder or bowel prolapse.

How successful is this surgery?

Studies show that 80 to 90% of women having sacrocolpopexy are cured of their prolapse and prolapse symptoms. Following surgery there is a small risk of prolapse developing in another part of the vagina, such as the front wall that supports the bladder. If this does develop it may require further surgery.

Hysterectomy

A hysterectomy is the surgical removal of the uterus and can also include the ovaries and the fallopian tubes. A hysterectomy stops the menstrual cycle and prevents pregnancy. It is a permanent procedure that cannot be reversed.

Some reasons for a hysterectomy include:

  • Uterine fibroids
  • Endometriosis
  • Uterine Prolapse
  • Pelvic adhesions
  • Persistent pain and bleeding
  • cancer

A total hysterectomy removes the uterus and cervix. It may also remove the ovaries and fallopian tubes. A subtotal hysterectomy removes the uterus but leaves the cervix. A radical hysterectomy removes the uterus, cervix, tubes, ovaries, and the pelvic lymph nodes.

**If you still have your uterus, the hysterectomy can be performed at the same time as the Sacrocolpopexy.

The da Vinci System is a robotic-assisted surgical device that your surgeon is 100% in control of at all times. The da Vinci System gives surgeons:

  • 3D HD view inside your body
  • Wristed instruments that bend and rotate far greater than the human hand
  • Enhanced vision, precision and control

da Vinci Hysterectomy offers the following potential benefits compared to traditional open surgery:

  • Lower complication rate
  • Shorter hospital stay
  • Less blood loss and less chance for a transfusion
  • Lower hospital readmission rate

da Vinci Hysterectomy offers the following potential benefits compared to traditional laparoscopy:

  • Lower complication rate
  • Shorter hospital stay
  • Less blood loss & less chance of blood transfusion
  • Less chance of surgeon switching to open surgery

da Vinci Hysterectomy offers the following potential benefits compared to vaginal surgery:

  • Shorter hospital stay
  • Less blood loss

Are there any complications?

The most commonly reported complications for both open and laparoscopic techniques include:

  • Pain (generally or during intercourse) in 2-3%
  • Exposure of the mesh in the vagina in 2-3%
  • Damage to the bladder, bowel or ureters in 1-2%

There are also general risks associated with surgery that include wound infection, urinary tract infection, bleeding requiring a blood transfusion and deep vein thrombosis (clots) in the legs, chest infection and heart problems. At the site where the mesh is anchored to the bone rarely there can be infection, or pain associated with the procedure. You may also be at risk for injury to the lower extremities due to positioning in the stirrups. Your surgeon or anesthetist will discuss any additional risks that may be relevant to you.

What preparations are needed before surgery?

Medications like Aspirin taken regularly affect the clotting system and may need to be stopped before surgery. Some surgeons recommend bowel preparation prior to surgery and your doctor will instruct you if this is required. In most cases you will be asked to avoid food and fluid for 6 hours before surgery.

Recovery after the Surgery

You can expect to stay in the hospital for one overnight stay. During the first 2 weeks you should avoid any type of heavy house work, lifting, including shopping bags, laundry baskets, vacuuming, etc.

Gentle walking is good exercise. Start with about 10 minutes a day when you feel ready and build up gradually; avoid any fitness type training, aerobics, etc for at least 6 weeks after surgery. Swimming, spa baths and intercourse should also be avoided for 6 weeks following surgery. Generally you will need 2 to 4 weeks off work, this period may be longer if you have a very physical job.

** The da Vinci System has brought minimally invasive surgery to more than 3 million patients worldwide. da Vinci technology – changing the experience of surgery for people around the world.