Robot-assisted, laparoscopic surgery for vaginal vault prolapse found to be effective

Rochester, Minn. -- Mayo Clinic researchers have found that laparoscopic surgery assisted by a surgical robot to fix vaginal vault prolapse, a collapse of the vagina that can occur after a hysterectomy, is an effective option to the traditional, open surgical repair when measured at least a year after the surgery. Findings are published in the August issue of Journal of Urology.

In the United States, one out of nine women will undergo hysterectomy, a surgery to remove all or parts of the uterus. Ten percent of these will develop vaginal vault prolapse.

"After hysterectomy, there's a lack of support for the vagina as you remove the ligaments, and the vagina can fall down," says Daniel Elliott, M.D., Mayo Clinic urologist and lead study investigator. "To imagine this, it helps to think of the vagina like a tube sock that's inverted out. For some women, the vagina can come completely out -- like three to five inches.

"This problem can be devastating both physically and socially," he says. "Sometimes the patients can hardly walk."

The new laparoscopic surgery has advantages over the traditional repair, open sacrocolpopexy, according to Dr. Elliott. These include:

  • Less overall recovery time

  • An overnight hospital stay only, rather than two to four days

  • Potentially lower risk of post-surgery bleeding

  • Markedly less pain, where 50 percent of patients go home taking only over-the-counter pain relievers

  • Women who may not tolerate the open procedure due to health issues may be candidates for this surgery

"My prediction is, with enough time and training, the robot-assisted, laparoscopic surgery will be the main procedure done in the future for women with major vaginal vault prolapse," says Dr. Elliott.

The surgery is not widely available at present, due to the small number of surgeons trained in the proc

Contact: Lisa Lucier
Mayo Clinic

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