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Notes on Women's Health
Notes on Women's Health

da Vinci surgery, pelvic organ prolapse and sacrocolpopexy

Along with uterine fibroids, which I discussed in my last blog, one of the conditions I treat pretty regularly is pelvic organ prolapse. This is a relatively common condition, affecting more than a third of all women at some point in their lives. It can occur in women of all ages, but it’s more common as women get older. It’s also more common among women who have had a difficult labor or recent abdominal surgery such as a hysterectomy. Smoking, obesity, respiratory disorders and repetitive strain injuries can all make pelvic organ prolapse more likely.

Prolapse literally means “to fall out of place”. When pelvic organ prolapse occurs, organs such as the uterus or bladder fall down or slip out of place, often pushing into or through the vagina. Pelvic organ prolapse can be uncomfortable and it can interfere with urination, bowel movements and sexual activity.

Going back just a decade or so, the most common treatment options for serious pelvic organ prolapse cases were relatively limited. Reconstructive surgery was one option, and hysterectomy was another. Today, an increasingly common option is called sacrocolpopexy. This is an open surgery in which soft synthetic mesh is used to permanently hold the vagina in the correct anatomical position. After the surgery, your body creates tissue that grows through and around the mesh, helping to restore your anatomy to its natural position and reinforcing the structures around your vagina to maintain support.

This is where da Vinci technology comes in. Instead of the 15-30 cm incision needed for a “regular”, open-surgery sacrocolpopexy, the da Vinci system uses five very small abdominal incisions and state-of-the-art computer technology to convert my hand movements into precise movement of the da Vinci surgical instruments. The procedure usually takes only one or two hours.

As with other da Vinci procedures, da Vinci sacrocolpopexy can provide several advantages. Compared to open abdominal surgery, there’s typically less bleeding, less pain, minimal scarring, quicker recovery, a shorter hospital stay, and a lower likelihood of complications. After a da Vinci sacrocolpopexy, most women usually return home the next day. Many women resume most normal daily activities within four days and recover in two to three weeks, although heavy lifting, strenuous exercise and sexual intercourse should be avoided for up to six weeks.

Sacrocolpopexy also can be performed as a preventative measure. If you or someone you know has decided to have a hysterectomy, sacrocolpopexy can be done after the hysterectomy to provide long-term support of the vagina.

Here are a few quotes from women who have had da Vinci sacrocolpopexy. These quotes and the stories behind them can be found on www.davincistories.com.

I had a problem with uterine prolapse and urination. I am 100% better after having da Vinci Surgery. Recovery was very fast. There was no pain or discomfort. I was back to work in three weeks, but I could have gone back sooner. I would definitely recommend this surgery to anyone who needs it. It was a breeze.” – Velma, Norwalk CT

I would not think twice about having another surgery with the da Vinci surgical method. I cannot tell you how pleased I am with my outcome, and I am only five days post-op.” – Diane, North Haven CT

If you live in Connecticut, Dr. Garofalo is a gynecologist serving the Stamford and Bridgeport metro areas.