Robotic Management of Mesh-Related Sacrocolpopexy Complications: Strategies for Mesh Challenges

Introduction: Pelvic organ prolapse (POP) is a condition where weakened pelvic muscles allow pelvic organs to slip down and bulge through the vaginal canal; it affects 30% of women to varying degrees.1,2 Around 300,000 surgeries are performed each year in the United States, accounting for 10–19% of women.2 This number is expected to increase given the aging population and improvements in quality of life.2 Unfortunately, these patients have a 15.9% risk of necessitating further re-intervention due to adverse effects or failure.3 Abdominal sacrocolpopexy is the current gold standard repair for vaginal vault prolapse and includes the placement of a mesh. Polypropylene is the most popular synthetic materials.4–6 Intraoperative risks such as presacral bleeding, injury to the urinary system, and postoperative complications account for 3–10% of cases.7,8 This video showcases three cases of mesh-related complications along with their respective approaches and techniques.