Factors associated with intraoperative conversion during robotic sacrocolpopexy
Int. braz. j. urol
;
41(2): 319-324, Mar-Apr/2015. tab
Article
in English
| LILACS
| ID: lil-748305
ABSTRACT
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. .
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Vagina
/
Pelvic Organ Prolapse
/
Conversion to Open Surgery
/
Robotic Surgical Procedures
Type of study:
Etiology study
/
Evaluation studies
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2015
Type:
Article
Affiliation country:
United States
Institution/Affiliation country:
Mayo Clinic/US
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