Yonsei Med J.  2016 Jul;57(4):1029-1033. 10.3349/ymj.2016.57.4.1029.

Robotic Single-Site® Sacrocolpopexy: First Report and Technique Using the Single-Site® Wristed Needle Driver

• Lee SR

• KMID: 2374139
• DOI: http://doi.org/10.3349/ymj.2016.57.4.1029

Abstract

The recently introduced da Vinci Single-Site® platform offers cosmetic benefits when compared with standard Multi-Site® robotic surgery. The innovative endowristed technology has increased the use of the da Vinci Single-Site® platform. The newly introduced Single-Site® Wristed Needle Driver has made it feasible to perform various surgeries that require multiple laparoscopic sutures and knot tying. Laparoscopic sacrocolpopexy is also a type of technically difficult surgery requiring multiple sutures, and there have been no reports of it being performed using the da Vinci Single-Site® platform. Thus, to the best of our knowledge, this is the first report of robotic single-site (RSS) sacrocolpopexy, and I found this procedure to be feasible and safe. All RSS procedures were completed successfully. The mean operative time was 122.17±22.54 minutes, and the mean blood loss was 66.67±45.02 mL. No operative or major postoperative complications occurred. Additional studies should be performed to assess the benefits of RSS sacrocolpopexy. I present the first six cases of da Vinci Single-Site® surgery in urogynecology and provide a detailed description of the technique.

Keyword

Laparoscopy; pelvic organ prolapse; robotic surgical procedures; sacrum

Figure

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  Fig. 1 (A) Silicon port for the da Vinci Single-Site® inserted through the Alexis-applied intraumbilical opening. (B) Final scar at the end of surgery. (C) The scar at postoperative 6 weeks. (D) Centrally docked da Vinci Si system. (E) Patient table tilted into the Trendelenburg position and rolled to the left for the retraction of the right colon.

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  Fig. 2 (A) Insertion of the needle in the two-to-seven-o'clock direction using the Single-Site® Wristed Needle Driver. (B) The needles used for the intracorporeal suturing were poked into the fat layer of right lower abdominal wall rather than being removed immediately after the completion of the suturing.

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  Fig. 3 Schematic drawing representing the insertion and removal of the curved needle through the accessory port positioned in the silicon port for the Robotic Single Site Surgery. (A) Silicon port not obscuring the insertion path of the curved needle. (B) The silicon port can obscure the removal path of the curved needle.

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