Faculty, Staff and Student Publications

Language

English

Publication Date

1-29-2026

Journal

Turkish Journal of Obstetrics and Gynecology

DOI

10.4274/tjod.galenos.2026.76906

PMID

41608873

Abstract

Objective: Sacral colpopexy is a well-established procedure for apical suspension, but the relative outcomes of abdominal, laparoscopic, and vaginal approaches remain debated. This study compared perioperative outcomes across these surgical routes using a national database and evaluated trends in robotic assistance.

Materials and methods: We analyzed sacral colpopexy cases from the American College of Surgeons National Surgical Quality Improvement Program between 2014 and 2022. Patient demographics, complication rates, and surgical outcomes were compared among abdominal, laparoscopic, and vaginal procedures. Relative risks (RR) were adjusted for confounders. The utilization of robotic systems in laparoscopic procedures was examined.

Results: Among 61,524 cases, 3,497 (5.7%) were abdominal, 22,752 (37.0%) laparoscopic, and 35,275 (57.3%) vaginal. Vaginal procedures were more common in older patients, while laparoscopic approaches predominated among younger and higher-body mass index patients. Non-Hispanic White patients most often underwent vaginal surgery (60.5%), whereas African American patients most frequently underwent laparoscopic procedures (6.4%). Laparoscopic sacral colpopexy had the lowest complication rate (7.8%), with fewer superficial surgical site infections, transfusions, readmissions, and reoperations. Adjusted analysis showed a lower risk with laparoscopic surgery compared with abdominal surgery [RR: 0.75, 95% confidence interval (CI): 0.67-0.85]. Vaginal surgery showed no significant difference compared with abdominal surgery (RR: 1.09, 95% CI: 0.97-1.21). Robotic assistance increased markedly, comprising 73.5% of laparoscopic procedures in 2022.

Conclusion: Laparoscopic sacral colpopexy, particularly with robotic assistance, is associated with fewer perioperative complications compared with abdominal and vaginal approaches. These findings support minimally invasive techniques as preferred approaches for apical suspension, and further research is needed on long-term outcomes and cost-effectiveness.

Keywords

Sacral colpopexy, apical suspension, laparoscopic surgery, pelvic organ prolapse, robotic surgery, surgical outcomes

Published Open-Access

yes

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