Safety of robot-assisted sacrocolpopexy in pelvic organ prolapse: systematic review

Aim. To evaluate safety of robot-assisted access compared to laparoscopic, abdominal, and vaginal accesses during sacrocolpopexy for pelvic organ prolapse.

Materials and methods. Randomized and non-randomized trials involving women suffering from pelvic organ prolapse were included in the analysis. A search for studies published prior to January of 2026 was performed in the PubMed, Medline and Cochrane Library databases. The following key words were used: robotic, sacrocolpopexy, and pelvic organ prolapse. Articles describing other types of interventions and articles without comparative analysis were not included in this review.

Results. In total, 36 studies were selected for the systematic review. The rate of postoperative complications in robot-assisted sacrocolpopexy was comparable to the rates in surgeries without the use of robotic devices. The volume of intraoperative blood loss did not differ from the volume during standard intervention through laparoscopic or abdominal access, but in vaginal access blood loss volume was significantly higher. Additionally, conversion rate for robot-assisted access was lower than for laparoscopic access. However, laparoscopic and vaginal accesses were characterized by shorter operative time compared to robot-assisted sacrocolpopexy. In-hospital time was shorter for robot-assisted access but compared to vaginal surgeries, no significant differences were observed.

Conclusion. Robot-assisted sacrocolpopexy might be associated with the following benefits: lower blood loss compared to vaginal access and shorter hospitalization time compared to laparoscopic sacrocolpopexy. However, more accurate and objective confirmation of safety of robot-assisted sacrocolpopexy requires further high-quality prospective randomized trials.

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