Here we present a video recorded in 3D of a robot-assisted mesh sacrocolpopexy and hysterectomy for stage 3 pelvic organ prolapse. Since the advent of the da Vinci Surgical System, robot-assisted hysterectomy has become an increasingly popular form of minimally invasive gynaecologic surgery, especially in the United States. The uptake in Australia has somewhat lagged behind, especially in the area of benign gynaeologic disease. Despite the number of robot-assisted hysterectomies increasing overall, other procedures such as mesh sacrocolpopexy and myomectomy are still in large part unfunded by the private health care funds, thus limiting the number of robot-assisted mesh sacrocolpopexies being done in this country. The available evidence now shows that robot-assisted mesh sacrocolpopexy has equivalent efficacy in terms of anatomical restoration and subjective improvement in quality of life as conventional laparoscopic sacrocolpopexy, but the operating time and costs are still significantly greater.

We have recorded this video in 3D to share our experience with a robot-assisted mesh sacrocolpopexy with concomitant hysterectomy. The 3D vision offered by the da Vinci robot is one of its innovative features, allowing for high-definition visualization and improved depth perception, which is useful when performing the difficult dissections at the sacral promontory and the pararectal spaces. Through this 3D video, we hope to recreate some of the immersive surgeon console experience for the audience members while performing a robot-assisted hysterectomy. The degrees of freedom available with the robotic instrument arms are also demonstrated in clarity, especially when performing intracorporeal suturing. This video will showcase how the robotic experience differs from conventional laparoscopy with performing a more complex procedure like mesh sacrocolpopexy.