Having Robotic-Assisted Sacrocolpopexy (RASC)

Robotic-assisted sacrocolpopexy is a type of surgery to repair pelvic organ prolapse. The surgery is done with special tools and a robotic controller.

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)

• Are pregnant or think you may be pregnant

• Plan to get pregnant after having this surgery

Tests before your surgery

Before your surgery, a healthcare provider will ask you questions about your health. They will also examine you. This includes a pelvic exam. Your heart and lungs will also be checked. You may need tests such as:

• Electrocardiogram (ECG) to check your heart rhythm

• Blood tests to check your overall health

• Urine test to check for infection

• Bladder tests to check how well you empty your bladder

Getting ready for your surgery

Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also make sure to do the following:

• Ask a family member or friend to take you home from the hospital.

• Follow any directions you are given for not eating or drinking before surgery.

• Follow all other instructions from your healthcare provider.

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.

On the day of your surgery

Your healthcare provider will explain the details of your surgery. Your surgery may be done by a gynecologic surgeon. This is a provider who specializes in female health. Or your surgery may be done by a urologist. This is a surgeon who specializes in the urinary system. They will work with a team of specialized nurses. The surgery can be done in several ways. Ask your provider about the details of your surgery. The whole procedure may take a couple of hours. In general, you can expect the following:      

• You will have general anesthesia, a medicine that allows you to sleep through the surgery. You won’t feel any pain during the surgery.

• A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the surgery.

• You may be given antibiotics during and after the surgery. This is to help prevent infection.

• After cleaning your skin, the surgeon will make a few small cuts (incisions) in your abdomen.

• A small tube may be used to send some gas into your abdomen. This helps the surgeon see the area better during surgery.

• The surgeon will pass tools through the small incisions. These include a tiny camera with a light, and several robotic tools. The robotic tools allow your surgeon to make very small movements.

• If you are going to have a hysterectomy, the surgeon will remove your uterus.

• The surgeon will lift up the prolapsed part of your vagina.

• The surgeon will sew a tissue graft or synthetic mesh under the pelvic organs. This helps keep them in place. The graft or mesh is stitched (sutured) to strong tissue in the pelvic area. Ask your surgeon if they plan to use mesh and what the risk are.

• The surgeon may also repair other prolapsed pelvic organs. These may include your rectum or bladder.

• When the surgery is done, the surgeon will remove the tools. The incisions will be closed and bandaged.

After your surgery

After the surgery, a healthcare provider will watch your vital signs. They will also check your incisions. You may be able to go home the same day. Or you may need to stay overnight.

Recovering at home

Make sure you move around as much as possible after your surgery. This helps to prevent problems like blood clots. You may have some pain after the surgery. This includes pain in your shoulder from the gas used during surgery. Your healthcare provider will tell you what to take for pain.

It's very important to not strain after this surgery. You may need to use stool softeners after surgery to prevent constipation.

Follow-up care

Make sure you follow all of your healthcare provider’s instructions. Don’t miss any of your follow-up appointments. Your symptoms may go away fully after surgery. Talk with your healthcare provider if your symptoms don’t go away, or if they return. Tell your provider if you get pregnant after having this surgery.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Pain that is getting worse

• Redness or warmth near the incisions

• Vaginal bleeding

• Lots of fluid leaking from your incisions

• Nausea and vomiting

• Chest pain or shortness of breath starts suddenly