We recently published an article on robotic surgery for urologic cancer. Today, we have a companion piece: robotic surgery for urogynecology.
As with all content on our blog, the information provided in this article is meant to be educational in nature, not medical advice. Always consult a physician regarding your specific health needs.
EDITOR'S NOTE: This post was reviewed and updated on July 21, 2025.
First, in general terms, describe robotic surgery for urogynecology. What is it used for?
GBU: Robotic surgery is a minimally invasive surgical technique that is primarily used in urogynecology to treat pelvic organ prolapse. It is performed through small abdominal incisions with the assistance of robotic surgical arms remotely controlled by the surgeon.
What are the biggest benefits that robotic surgery offers?
GBU: Robotic surgery has many advantages. First of all, it allows for enhanced surgeon dexterity and instrument maneuvering, thanks to the robotic instruments' 360-degree wrist movement. Second, the robotic system's 3D magnified camera enables superior visualization of organs, tissues, and surgical planes. And finally, it allows the doctor to reach the deep aspects of the pelvis, which is especially necessary when performing prolapse surgery.
All of these advantages lead to better patient outcomes, including reduced blood loss, less post-operative pain, and quicker healing and return to normal activity.
Does insurance typically cover urogynecologic robotic surgery?
GBU: Yes, robotic surgery in urogynecology, like in many other surgical specialties, is now a common surgical approach and is covered by insurance companies.
Now, let's discuss robotic sacrocolpopexy. When would this treatment option be considered? What does it entail?
GBU: Robotic sacrocolpopexy is usually considered when women present with either bothersome uterine prolapse or vaginal vault prolapse (if they previously had a hysterectomy). Both conditions go under the umbrella of “apical prolapse,” which means that the top of the vagina—the highest/deepest part of the vaginal canal—has everted (in other words, turned inside out).
Robotic sacrocolpopexy can also be considered when other aspects of the vagina have prolapsed along with the vaginal apex, such as the anterior wall dragging along the bladder or the posterior wall usually dragging along the rectum.
Sacrocolpopexy entails the use of a surgical mesh that lifts up the prolapsed vagina inside of a woman’s body and connects it to a strong ligament covering the sacrum. This surgery has the highest success rate among all reconstructive (corrective) vaginal prolapse surgeries, reaching up to 90%.
Of course, each woman’s condition is unique, and robotic sacrocolpopexy is only one of many options available to treat pelvic organ prolapse. A thorough medical evaluation and exam, as well as a discussion of the benefits, risks, and alternatives, are necessary before making a shared decision concerning the best surgical treatment for the individual patient.
And what about robotic total hysterectomy with bilateral high uterosacral ligament suspension. When would you offer this option? What does it entail?
GBU: This procedure is primarily offered to women with a predominantly apical uterovaginal prolapse. The primary difference between this procedure and robotic sacrocolpopexy is that no mesh is used in this surgery, making it suitable for individuals who wish to avoid mesh.
It entails performing a total hysterectomy robotically, followed by connecting the vaginal cuff (top of the vaginal canal after removal of the uterus) with sutures to the most proximal (highest point possible) part of the uterosacral ligaments (the actual ligaments that naturally support the cervix and upper vagina). This allows us to lift the top of the vagina up inside and restore normal anatomy of the vaginal canal.
If there's one point about robotic surgery that you want to make sure readers take away, what would it be?
GBU: Robotic surgery is an excellent surgical route for the management of pelvic organ prolapse. It is, however, not the only option. At GBU, we help patients determine the best surgical treatment option for them by conducting a thorough evaluation and discussing their preferences, options, risks, benefits, and personal goals.
Interested in learning more?
Read more about urogynecology here.