Factors associated with intraoperative conversion during robotic sacrocolpopexy.
Int Braz J Urol
; 41(2): 319-24, 2015.
Article
in En
| MEDLINE
| ID: mdl-26005974
ABSTRACT
OBJECTIVE:
To evaluate for potential predictors of intraoperative conversion from robotic sacrocolpopexy (RSC) to open abdominal sacrocolpopexy. PATIENTS ANDMETHODS:
We identified 83 consecutive patients from 2002-2012 with symptomatic high-grade post-hysterectomy vaginal vault prolapse that underwent RSC. Multiple clinical variables including patient age, comorbidities (body-mass index [BMI], hypertension, diabetes mellitus, tobacco use), prior intra-abdominal surgery and year of surgery were evaluated for potential association with conversion.RESULTS:
Overall, 14/83 cases (17%) required conversion to an open sacrocolpopexy. Patients requiring conversion were found to have a significantly higher BMI compared to those who did not (median 30.2 kg/m(2) versus 25.8 kg/m(2); p=0.003). Other medical and surgical factors evaluated were similar between the cohorts. When stratified by increasing BMI, conversion remained associated with an increased BMI. That is, conversion occurred in 3.8% (1/26) of patients with BMI ≤ 25 kg/m(2), 14.7% (5/34) with BMI 25-29.9 kg/m(2) and 34.7% (8/23) with BMI ≥ 30 kg/m(2) (p=0.004). When evaluated as a continuous variable, BMI was also associated with a significantly increased risk of conversion to an open procedure (OR 1.18, p=0.004).CONCLUSIONS:
Higher BMI was the only clinical factor associated with a significantly increased risk of intra-operative conversion during robotic sacrocolpopexy. Recognition of this may aid in pre-operative counseling and surgical patient selection.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vagina
/
Pelvic Organ Prolapse
/
Conversion to Open Surgery
/
Robotic Surgical Procedures
Type of study:
Etiology_studies
/
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Int Braz J Urol
Journal subject:
UROLOGIA
Year:
2015
Document type:
Article
Affiliation country:
United States