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Subject A Team Led by Professor Jung-Ho Shin of Department of Obstetrics and Gynecology of Korea University Guro Hospital, Performed More Than 100 Cases of Single-Port Robotic Surgery for Pelvic Organ Prolapse First Time in the World
Selection News Date 2020-08-04 Read 90

A Team Led by Prof. Jung-Ho Shin of

 

Dpt. of Obstetrics and Gynecology of Guro Hospital,

 

Performed More Than 100 Cases of Single-Port

 

Robotic Surgery for Pelvic Organ Prolapse

 

First Time in the World

 

 

 

Single-port robotic-assisted sacrocolpopexy reduces operating time by 1/3

 

Better cosmetic outcome, faster recovery, lower odds of recurrence

 

 

 

A team led by Professor Jung-Ho Shin of Department of Obstetrics and

 

Gynecology of Korea University Guro Hospital became the first hospital-based

 

team to perform more than 100 cases of robotic-assisted sacrocolpopexy for

 

pelvic organ prolapse. 

 

 

A prolapse happens when one or more of the pelvic organs (bladder, rectum,

 

uterus) drop or press into or out of the vagina. It is common in middle-aged

 

women affecting three in ten women aged over 50 with a history of

 

childbirth. Symptoms include urinary problems, vaginal bleeding, pelvic pain,

 

gait disturbances and significantly decrease quality of life, so it is important for

 

patients to seek treatment. Symptoms get worse as one gets old after

 

menopause, so the cases requiring surgery increases with age. Surgery is mostly

 

performed on patients in their 70s.

 

 

However, the risk of recurrence is high after pelvic organ prolapse surgery; one

 

in three requires repeat surgery. Recurrence prevention is very important and

 

sacrocolpopexy in which a mesh is attached from the vagina to the sacrum is

 

associated with a low risk of recurrence and good long-term outcome. This is a

 

highly complicated surgery that requires highly skilled surgeons because the

 

bladder and rectum should be separated from the vagina in a shallow pelvic

 

cavity and the sacrum is exposed, which has a high risk of bleeding. Moreover,

 

this approach is more challenging and there is a long learning curve for

 

surgeons.

 

 

In the past, laparoscopy or laparotomy was performed, but these procedures

 

make a large incision or take 4 to 5 hours or more even with few trocars. This

 

can be difficult for frail elderly patients who have chronic diseases and

 

diminished physiologic reserve. However, a single-port robotic-assisted

 

procedure can decrease the operating time 3 hours, decreasing the time under

 

anesthesia by 1/3. The incision is small at about 3cm, less demanding on the

 

patient’s body and thus, faster recovery.

 

 

 

“It is important to minimize the risk and burden of surgery because most of the

 

patients requiring sacrocolpopexy are middle-aged patients, especially elderly

 

patients aged over 70,” Professor Shin stated. “Our team makes only one

 

incision for single-port robotic-assisted surgery, reducing operating time, and

 

minimizing the incision site so that patients can start walking a half-day after

 

the surgery; recovery is faster. Also, single-port robotic surgery enables

 

surgeons to access the pelvic cavity more easily than other procedures.”

 

 

Korea University Guro Hospital is equipped with Da Vinci Xi, a surgical system

 

capable of challenging surgeries, and Da Vinci SP, the best single-port robotic

 

surgical system to date. It is leading the development of robotic surgery based

 

on unparalleled surgical techniques. For example, it succeeded in single-port

 

surgery for the first time in Korea not only for pelvic organ prolapse but also for

 

lung cancer.

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