http://www.ga-advancedsurgerycenter.com/client_files/file/Laparoscopic-Vs%20-Robotic-Surgery.pdf

Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial.

This prospective multi-centre true two-sided equivalence trial was designed to test the clinical equivalence of open (ASCP) and laparoscopic (LSCP) sacrocolpopexy using objective and subjective outcomes The study was carried out in three urogynaecology units in England, UK and the patient population consisted of women referred with symptomatic and bothersome post-hysterectomy vaginal vault prolapse at least 1 cm above or beyond the hymeneal remnants. The interventions were either abdominal or laparoscopic sacrocolpopexy following randomisation to one of the types of surgery. For the primary outcome (point C on the POP-Q) the results at 1 year were −6.63 cm for the open ASCP and −6.67 cm for the LSCP respectively. Subjective outcomes at 1 year showed that 90% of the ASCP group and 80% of the LSCP group were “much better”. There were improvements with regard to blood loss, haemoglobin and shorter length of stay in the LSCP group compared with the ASCP group. This fully powered randomised controlled trial comparing open and laparoscopic sacrocolpopexy has shown clinical equivalence.

A randomised controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study.

https://www.europeanurology.com/article/S0302-2838(13)01492-9/pdf/a-review-of-the-current-status-of-laparoscopic-and-robot-assisted-sacrocolpopexy-for-pelvic-organ-prolapse

A Review of the Current Status of Laparoscopic and Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse

Cost-Minimization Analysis of Robotic-Assisted, Laparoscopic, and Abdominal Sacrocolpopexy

Pelvic organ prolapse is showing an increasing prevalence (3 – 50 %). The gold standard treatment of apical prolapse is sacrocolpopexy which can be performed via minimal access (laparoscopy or robotics) or open approaches. The aim of this review was to appraise the effectiveness of minimal access surgery versus the open approach in the treatment of apical prolapse. Keywords were searched in: CINAHL, MEDLINE, CENTRAL, Cochrane MDSG Trials Register, Cochrane Library, Current Controlled Trials, ClinicalTrials.gov, WHO International Trials Registry Platform search portal, LILACS, and Google Scholar databases. Data up to 31 April 2014 were considered. Randomized and nonrandomized controlled trials evaluating all women who underwent minimally invasive sacropexy (MISC) and open sacropexy (OSC) were included. A data extraction tool was used for data collection. MISC was compared with OSC using narrative analysis and meta-analysis (RevMan) where appropriate. MISC and OSC were compared in 12 studies involving 4,757 participants. MISC and OSC were equally effective in terms of point-C POP-Q measurements and recurrence rate. MISC was associated with a lower transfusion rate (odds ratio 0.41, 95 % CI 0.20 – 0.83), shorter length of hospital stay (mean difference −1.57 days, 95 % CI −1.91 – −1.23 days), and less blood loss (mean difference −113.27 mL, 95 % CI −163.67 – −62.87 mL) but a longer operating time (mean difference 87.47, 95 % CI 58.60 – 116.34, p < 0.0001). MISC showed similar anatomic results to OSC with a lower transfusion rate, shorter length of hospital stay and less blood loss. The rate of other complications was similar between the approaches. Cautious interpretation of results is advised due to risk of bias caused by the inclusion of nonrandomized studies.

Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis

The purpose of this study was to compare anatomic and perioperative outcomes following laparoscopic sacral colpopexy (LSC) and abdominal sacral colpopexy (ASC). The hypothesis is that the laparoscopic technique has similar anatomic outcomes as compared with the open technique. A retrospective comparative chart review was conducted consisting of 43 patients who underwent laparoscopic sacral colpopexy and 41 patients who underwent abdominal sacral colpopexy. Demographics were comparable between groups except mean follow-up time (LSC = 7.4 months, ASC = 10.6 months). Mean improvement at the apex was similar between the two groups. Hospital stay in hours was shorter for the LSC group (mean/median = 35.4/30.9) than the ASC group (mean/median = 63.3/54.1, p < 0.001). Mean operative time was similar (LSC = 183, ASC = 168 min, p = NS) and complication rates were comparable between the groups. Patients undergoing laparoscopic and abdominal sacral colpopexy have comparable anatomical outcomes and operative times. Laparoscopy affords a shorter hospital stay.

A comparison of laparoscopic and abdominal sacral colpopexy: objective outcome and perioperative differences

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A comparison of laparoscopic and abdominal sacral colpopexy: objective outcome and perioperative differences