Robotic Burch colposuspension: anatomical and technical considerations

Erryn Tappy, Evelyn Pan, Marlene Corton

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and hypothesis: Up to 13.6% of women will undergo surgical treatment for stress urinary incontinence during their lifetime. Midurethral slings are the mainstay of stress incontinence treatment; however, diversity of surgical options is needed to serve the large number of patients desiring treatment. The Burch colposuspension remains a viable treatment option for appropriately selected patients. Currently, information on procedural standardization and tools for surgical training on robot-assisted colposuspension is limited. Methods: We describe a stepwise robotic approach aimed at enhancing procedural reproducibility, while decreasing risks of intraoperative injury and postoperative complications. We analyze perioperative outcomes of our technique in a retrospective cohort of patients who underwent robot-assisted colposuspension at our institution. Results: Seven key procedural steps are defined to optimize safe dissection in the retropubic space and to reduce the potential for surgical complications. These include methods of avoiding bladder, urethral, and neurovascular injury, as well as enhancing adequate suture fixation that prevents urethral obstruction and adverse postoperative urinary and pain-related symptoms. Surgical outcomes for 20 patients are reported and reveal low rates of perioperative complications. Conclusion: Robot-assisted colposuspension requires thorough knowledge of the retropubic space and the application of standardized techniques may reduce the risk of injury and optimize procedure efficiency and reproducibility.

Original languageEnglish (US)
Pages (from-to)1653-1657
Number of pages5
JournalInternational Urogynecology Journal
Volume34
Issue number7
DOIs
StatePublished - Jul 2023

Keywords

  • Robot-assisted colposuspension
  • Stress urinary incontinence
  • Surgical education

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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