Robotic Abdominal Sacrocolpopexy
    (Robotic assisted Laparoscopic Reconstruction)

    What is a Robotic Abdominal Sacrocolpopexy?
      The top of the vagina is supported by mesh with stitches that are attached to the front of the tail bone (sacrum). If necessary a vaginal repair of the bladder and bowel might also follow this procedure.

      When is this procedure done?
        · Chronic discomfort from bulging from the prolapse/fallen vagina
          · Difficulty with bowel movements
            · Difficulty emptying the bladder

            How is the surgery performed?
              The surgery is a minimally invasive surgery performed through four small openings on the abdomen (see picture below). The top of the vagina is then supported by attaching mesh with stitches to the front of the tail bone (sacrum). If a bulge in the vagina still remains, a vaginal repair can be done. The mesh and sutures used are permanent, but will not need to be removed.

              Where is the surgery performed?
                This procedure is an inpatient surgery (you will stay in the hospital for 1-2 days) performed at St. Mary’s Hospital Main Operating Room (second floor).

                What are possible risks from this surgery?
                  · Bleeding
                    · Infection
                      · Mesh erosion
                        · Damage to bowel
                          · Pain with intercourse
                            · Difficulty with bowel movements
                              · Failure of surgery

                              Rare risks from surgery
                                · Blood clot in the legs or lungs
                                  · Complications from anesthesia

                                  What will be the recovery time?
                                    Typical recovery for the procedure is 4 weeks. During the first week you will likely need to take pain pills which will likely make you feel tired and sleepy.

                                    What are the advantages and disadvantages?
                                      Advantages include:
                                        · Smaller incisions than abdominal surgery (see picture below), decreased blood loss, less pain, and quicker healing time
                                          · Recent studies support that the procedure is as effective as abdominal reconstruction which is a more durable/strong repair when compared with vaginal reconstruction.
                                            Disadvantages include:
                                              · Less evidence of the effectiveness of the procedure as compared to vaginal and abdominal reconstruction

                                              How do I prepare for surgery?
                                                Please contact Marilyn Turpin in Dr. Steele’s office at 706.612.9405
                                                  If you have any medical problems, make sure that you are cleared for surgery. Make sure you have all necessary lab work, EKG, or chest x-rays done at least 3 days before surgery.

                                                  Make sure your physician knows what medications, including herbal supplements, you are currently taking. Some medications need to be stopped for some time before the procedure:
                                                    · Coumadin
                                                      · Heparin
                                                        · Motrin or ibuprofen
                                                          · Plavix
                                                            · Lovenox
                                                              · Aspirin
                                                                · St. John’s Wort

                                                                Smoking can affect your recovery. Smokers heal more slowly after surgery and may have difficulty breathing during the surgery. If you are a smoker, it is best to quit 6-8 weeks before surgery.

                                                                Do I have any limitations afterward?
                                                                  Walking: Normal physical activity is expected within hours of your procedure. Start with short walks and gradually increase the distance and length of time that you walk.
                                                                    Climbing: Climbing stairs is permitted, but you may require some assistance initially.
                                                                      Lifting: Please limit lifting to less than 10 pounds (approximately one gallon container) for 4-6 weeks.
                                                                        Showers: Showers are allowed within 24 hours after your surgery. Refrain from baths for at least 1 week.
                                                                          Driving: Driving may be resumed 3-5 days after surgery, but be careful if taking prescription pain medications.
                                                                            Sex: Sex may be resumed 2-3 months after surgery.
                                                                              Work: Most patients will be able to return to work between 3-4 weeks after surgery. Some patients may have residual fatigue for a couple weeks.
                                                                                Diet: No dietary restrictions unless diabetic. Regular food as tolerated.
                                                                                  Pain: A pain medication will be prescribed for you after surgery. Do not take more frequently than indicated on the instructions.

                                                                                  Bowel Regimen: Following surgery use Miralax 17 g (one capful) daily until post op appointment to avoid constipation. If Miralax has not produced results within 4 days call office for instruction on possible use of milk of magnesia.

                                                                                  How long after surgery do I come back to follow-up?
                                                                                    At your pre-operative appointment, you will make a post op appointment with your physician between 4-6 weeks after surgery.

                                                                                    If you have questions following surgery, call our office at 706-612-9401 during normal working hours.

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