Robotic sacrocolpopexy plus ventral rectopexy as combined treatment for multicompartment pelvic organ prolapse using the new Hugo RAS system

Excerpt

Pelvic organ prolapse (POP) is a condition affecting up to 50% of multiparous postmenopausal women that is often associated with obstructed defecation syndrome and internal rectal prolapse. Surgical treatment of women with severe POP associated with obstructed defecation syndrome may be challenging, as surgery for such cases should ideally address all coexisting pelvic floor defects [1]. Various procedures have been described for combined treatment, and a multicompartmental assessment should be carried out before planning surgical repair. Minimally invasive ventral mesh rectopexy combined with minimally invasive sacrocolpopexy has gained increasing acceptance as a valid technique with excellent anatomical and functional outcomes [2‐4]. Robotic-assisted surgery (RAS) has the aim of increasing feasibility and reducing invasiveness of surgical procedures, and has shortened the surgical learning curve [5]. In recent years, new robotic platforms other than the most widely available platform (da Vinci Surgical Systems by Intuitive, CA, USA) have emerged. Hugo RAS robotic system (Medtronic, Minneapolis, MN, USA) is the newest alternative to traditional robotic systems. Its features include independent arm carts, which can be used with a three- or four-arm configurations depending on the procedure, a system tower, and an open console [6, 7]. Hugo RAS was introduced in Europe in March 2022, receiving Conformité Européenne (CE) approval for gynecological and urological procedures. We present this video to show the surgical steps of robotic combined nerve-sparing sacral colpopexy and ventral rectopexy using Hugo RAS. …