TY - JOUR
T1 - Factors associated with intraoperative conversion during robotic sacrocolpopexy
AU - Linder, Brian J.
AU - Chow, George K.
AU - Hertzig, Lindsay L.
AU - Clifton, Marisa
AU - Elliott, Daniel S.
PY - 2015
Y1 - 2015
N2 - Objective: To evaluate for potential predictors of intraoperative conversion from robotic sacrocolpopexy (RSC) to open abdominal sacrocolpopexy. Patients and Methods: 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 30.2kg/m2 versus 25.8kg/m2; 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/m2, 14.7% (5/34) with BMI 25-29.9 kg/m2 and 34.7% (8/23) with BMI =30 kg/m2 (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.
AB - Objective: To evaluate for potential predictors of intraoperative conversion from robotic sacrocolpopexy (RSC) to open abdominal sacrocolpopexy. Patients and Methods: 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 30.2kg/m2 versus 25.8kg/m2; 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/m2, 14.7% (5/34) with BMI 25-29.9 kg/m2 and 34.7% (8/23) with BMI =30 kg/m2 (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.
KW - Obesity
KW - Pelvic organ prolapse
KW - Robotics
UR - http://www.scopus.com/inward/record.url?scp=84930835279&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930835279&partnerID=8YFLogxK
U2 - 10.1590/S1677-5538.IBJU.2015.02.19
DO - 10.1590/S1677-5538.IBJU.2015.02.19
M3 - Article
C2 - 26005974
AN - SCOPUS:84930835279
SN - 1677-5538
VL - 41
SP - 319
EP - 324
JO - International Braz J Urol
JF - International Braz J Urol
IS - 2
ER -