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Single-port robotic sacrocolpopexy has same learning curve as multiport



Single-port robotic sacrocolpopexy has the same learning curve as the multiport procedure – 15 cases, according to Israeli investigators.

Dr. Emad Matanes of the Rambam Medical Center, Haifa, Israel. M. Alexander Otto/MDedge News

Dr. Emad Matanes

Multiport sacrocolpopexy is common, but the single-port approach hasn’t really caught on yet. That’s likely to change, however, with ongoing development of the da Vinci robotic platform, said lead investigator Emad Matanes, MD, of the Rambam Medical Center, Haifa, Israel.

The medical center recently has been switching over to the single-port approach, and Dr. Matanes and his colleagues wanted to share their experience with surgeons considering doing the same.

They compared their first 52 multiport cases during Dec. 2011-Dec. 2012 to their first 52 single-port cases during Aug. 2015-Aug. 2017.

It took about 15 cases with either approach for operative times to stabilize, dropping from an average of 222 minutes to 161 minutes after the first 15 single-port cases, and from 224 to 198 minutes after the first 15 multiport cases (J Minim Invasive Gynecol. 2018 Nov-Dec;25[7]:S47-S8).

With both, “we reached our steady state after the first 15. Both approaches are feasible, and for both, surgery times improve after 15 cases,” Dr. Matanes said at the American Association of Gynecologic Laparoscopists Global Congress.

Overall, the single-port approach proved about 20 minutes quicker, due to shorter docking and anesthesia times.

There wasn’t a single prolapse recurrence in either group, even after the first few cases. There was slightly less postoperative pain with single-port surgery (visual analogue scale sore 1.5 vs. 2 points), and slightly less estimated blood loss (38 mL vs. 54 mL), but neither difference was statistically significant.

There were no statistically significant differences between women in the two groups. Their average age was 58 years, mean body mass index was 28 kg/m2, and most women had a preoperative Pelvic Organ Prolapse Quantification score of 3.

There was no outside funding, and Dr. Matanes didn’t disclose any relevant financial disclosures.

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