Single Site Robotic Assisted Laparoscopic Sacro-colpopexy 

The first case of Single Site Robotic Assisted Laparoscopic Sacro- colpopexy performed in Australia is described. A 73yo lady with vaginal vault prolapse presented for assessment and treatment. She denied any bladder or bowel disturbances. Through a 2.3cm umbilical incision, a gel port was inserted. Standard bipolar forceps and monopolar diathermy were used for coagulation and dissection respectively. Synthetic monofilament mesh was sutured to the anterior and posterior vaginal wall with continuous 2/0 barbed sutures. After identification of landmark of sacral promontory, 2/0 Gortex sutures were used to suture the mesh onto the anterior longitudinal ligament. The pelvic peritoneum was closed to avoid exposure of the mesh to the pelvic viscera. The console time was 75minutes and the patient was discharged in 22 hours . She retuned to normal activity in less than a week. On four weeks and six months postoperative followup visit, there was no surgical complications and there were no bladder or bowel disturbances. She remains sexually active and enjoyed an excellent quality of life.  

Abdominal sacro-colpopexy has been described as golden standard for recurrent vaginal vault prolapse. Laparoscopic approach reduces hospital stay and analgesic requirement. Robotic assisted approach has shorter learning curve, higher reproducibility and with comparable result. Long term follow up studies are needed to define the role of robot surgery in vaginal vault prolapse.