LAUSR

Study Objective To evaluate laparoscopic sacrocolpopexy operative times, complication rates and long-term surgical outcomes at one academic institution with significant trainee involvement. Design This is a retrospective chart review of laparoscopic sacrocolpopexy cases. Setting Cases took place in an operating room at a large academic medical center. Patients were in dorsal lithotomy position with five abdominal laparoscopic trocar sites. Patients or Participants A series of 181 consecutive laparoscopic sacrocolpopexy cases (with or without concomitant procedures) were examined between February 2014 and August 2019. Interventions None. Measurements and Main Results Descriptive statistics were used to compare primary outcomes with published literature. The average operative time was 139.9 minutes, compared to 180-190 minutes noted in other studies. Four cases of intraoperative cystotomy (2.2%) and one enterotomy (0.6%) were noted compared to 5-6% and 1.4% respectively in the literature (Sheyn et al 2019). There were 16 cases of postoperative urinary tract infection (8.8%). At their most recent postoperative visit, which occurred on average at postoperative day 278, recurrent prolapse was noted in 11.7% of patients and 3.9% of those patients underwent a subsequent repair to correct their prolapse. Other complications included 0.6% small bowel obstruction, 1.1% mesh erosion and 7.7% de-novo stress urinary incontinence; all of these were less than those documented in the literature. The overall complication rate was 15.4% compared to 18% in the literature (Nosti et al 2014). Conclusion This institutional demonstrates short operative times, low complication rates and favorable outcomes with resident involvement in laparoscopic sacrocolpopexy. This indicates advanced urogynecology procedures can be performed with significant resident involvement without compromising operative time and surgical outcomes.