BACKGROUND Multispecialty management should be the preferred approach for the treatment of pelvic floor dysfunction, as there is often multicompartmental prolapse. OBJECTIVE To assess the safety of combined robotic ventral-mesh rectopexy and either uterine or vaginal fixation for treatment of multicompartmental pelvic organ prolapse at our institution. DESIGN Retrospective analysis. SETTINGS Tertiary referral academic center. PATIENTS All patients who underwent a robotic approach and combined procedure and discussed at a biweekly pelvic floor multidisciplinary team meeting. MAIN OUTCOME MEASURES Operative time, intraoperative blood loss and complications. Postoperative pelvic organ prolapse quantification score, length of stay, 30-day morbidity, and readmission. RESULTS From 2018 to 2021, there were 321 operations for patients with multicompartmental prolapse. Mean age was 63.4 years. The predominant pelvic floor dysfunction was rectal prolapse in 170 cases (60%). Pelvic organ prolapse quantification scores were II in 146 patients (53%), III in 121 (44%), and IV in 9 (3%); 315 of the 323 cases included robotic ventral mesh rectopexy (98%). Sacrocolpopexy or sacrohysteropexy was performed in 281 patients (89%). Other procedures included 175 hysterectomies (54%), 104 oophorectomies (32%), 151 sling procedures (47%), 149 posterior repairs (46%), and 138 cystocele repairs (43%). The operative time for ventral mesh rectopexy was 211 minutes and combined pelvic floor reconstruction 266 minutes. Average length of stay was 1.6 days. Eight patients were readmitted within 30 days, 1 with a severe headache and 7 patients with postoperative complications (2.5%): pelvic collection, perirectal collection both requiring radiologic drainage. Four complications required reoperation: epidural abscess, small-bowel obstruction, missed enterotomy requiring resection, and urinary retention requiring sling revision. There were no mortalities. LIMITATIONS Retrospective single-center study. CONCLUSIONS A combined robotic approach for multicompartmental pelvic organ prolapse is a safe and viable procedure with a relatively low rate of morbidity and no mortality. This is the highest volume series of combined robotic pelvic floor reconstruction in the literature and demonstrates a low complication rate and short length of stay.

中文翻译：

---

联合机器人腹侧网状直肠固定术和骶骨阴道固定术治疗多室盆腔器官脱垂。

背景 多专业治疗应该是治疗盆底功能障碍的首选方法，因为经常出现多室脱垂。目的 评估我们机构联合机器人腹侧网状直肠固定术和子宫或阴道固定治疗多室盆腔器官脱垂的安全性。设计回顾性分析。设置 高等教育转介学术中心。患者 所有接受机器人入路和联合手术并在每两周一次的盆底多学科团队会议上进行讨论的患者。主要观察指标：手术时间、术中失血量和并发症。术后盆腔器官脱垂量化评分、住院时间、30 天发病率和再入院率。结果 2018年至2021年，多房室脱垂患者接受手术321例。平均年龄为 63.4 岁。170 例（60%）的主要盆底功能障碍是直肠脱垂。146 名患者（53%）的盆腔器官脱垂量化评分为 II，121 名患者（44%）为 III，9 名患者（3%）为 IV；323 例病例中的 315 例接受了机器人腹侧网状直肠固定术（98%）。281 名患者 (89%) 接受了骶骨阴道固定术或骶骨子宫固定术。其他手术包括 175 例子宫切除术 (54%)、104 例卵巢切除术 (32%)、151 例吊带手术 (47%)、149 例后路修复术 (46%) 和 138 例膀胱膨出修复术 (43%)。腹侧网状直肠固定术的手术时间为211分钟，联合盆底重建术的手术时间为266分钟。平均停留时间为1.6天。8 名患者在 30 天内再次入院，其中 1 名患者出现严重头痛，7 名患者出现术后并发症（2.5%）：盆腔收集、直肠周围收集均需要放射引流。四种并发症需要再次手术：硬膜外脓肿、小肠梗阻、需要切除的漏肠切开术以及需要吊带翻修的尿潴留。没有人员死亡。局限性 回顾性单中心研究。结论 联合机器人方法治疗多室盆腔器官脱垂是一种安全可行的手术，发病率相对较低，无死亡率。这是文献中容量最大的组合机器人盆底重建系列，并且并发症发生率低且住院时间短。