Ryan Stewart, DO
Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026

Robotic Sacrocolpopexy for Pelvic Organ Prolapse

Robotic sacrocolpopexy is a minimally invasive surgical procedure used to treat pelvic organ prolapse (POP), particularly apical (upper vaginal) prolapse. It uses robotic assistance to restore the normal support of the vagina and pelvic organs.

What is Robotic Sacrocolpopexy?

Robotic sacrocolpopexy is performed using the da Vinci robotic surgical system, which allows for greater precision and control compared to traditional laparoscopic techniques. The procedure involves:

1. Five small 8mm incisions are made in the abdomen
2. A lightweight synthetic mesh is positioned to support the prolapsed organs
3. The mesh is secured to the vagina and then attached to the anterior longitudinal ligament in the hollow of the sacrum

Sacrocolpopexy is widely considered the most durable surgical option for apical prolapse. The robotic system gives me better visualization and precision than I’d have with a traditional laparoscopic approach.

Benefits of Robotic Sacrocolpopexy

• Smaller incisions compared to open surgery
• Less blood loss and tissue trauma
• Shorter hospital stay (typically one night, or same-day discharge)
• Faster recovery compared to open procedures
• 3D high-definition imaging gives better visualization of the surgical field
• The robotic instruments allow for more precise suturing in tight spaces

How the procedure works

1. Preoperative evaluation, including imaging or urodynamic testing if needed
2. General anesthesia
3. Five small abdominal incisions (8mm each)
4. The da Vinci robot is docked and instruments are inserted
5. Dissection to identify the key anatomical structures
6. A lightweight synthetic mesh is attached to the vagina
7. The mesh is then secured to the anterior longitudinal ligament in the hollow of the sacrum
8. Incisions are closed with sutures

Recovery and Expectations

Most patients go home the same day or after one night in the hospital. Pain is managed with medications, and your first follow-up visit is typically at 6 weeks.

I don’t give patients a long list of postoperative restrictions. Instead, I tell them to let their body be their guide — if it hurts, don’t do it. Research by Mueller and Kenton has shown that strict activity restrictions after prolapse surgery don’t improve outcomes, and most patients do well with a common-sense approach to getting back to their normal routine.

Full recovery takes about 6-8 weeks. Most patients tell me they’re surprised by how quickly they bounce back compared to what they expected.

Who is a Candidate?

Robotic sacrocolpopexy may be a good option if you have:

• Symptomatic apical prolapse (the top of the vagina or uterus is dropping)
• A preference for a durable, long-term surgical repair
• Overall health that supports general anesthesia and surgery

It’s not the right fit for everyone, and we’ll talk through whether it makes sense for your situation during your consultation.

Potential Risks and Complications

Like any surgery, robotic sacrocolpopexy carries risks. These include:

• Bleeding, infection, or anesthesia complications
• Rare injury to bowel, bladder, or blood vessels
• Mesh-related complications (erosion, exposure, or contraction)
• Changes in urination (temporary or, rarely, permanent)
• Potential impact on sexual function

I go through all of these risks and benefits with you before surgery so you know exactly what to expect.

Alternative Treatments

Robotic sacrocolpopexy isn’t the only option. Other treatments for pelvic organ prolapse include:

• Pelvic floor physical therapy and pessary devices
• Vaginal native tissue repairs
• Open abdominal sacrocolpopexy (the same procedure through a larger incision)

You can read more about all treatment options on the pelvic organ prolapse page.

Success Rates and Outcomes

Studies show that 90-95% of patients achieve good anatomical correction after sacrocolpopexy, and long-term data supports the durability of the repair. Most patients see a real improvement in their symptoms.

Is this the right surgery for you?

That depends on the type and degree of your prolapse, your symptoms, your health, and what you’re hoping to get out of treatment. I’ll walk you through the options and help you figure out what makes the most sense for your situation.

References

1. Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309(19):2016-2024. doi:10.1001/jama.2013.4919
2. Anger JT, Mueller ER, Tarnay C, et al. Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2014;123(1):5-12. doi:10.1097/AOG.0000000000000006
3. Mueller MG, Lewicky-Gaupp C, Collins SA, et al. Activity restriction recommendations and outcomes after reconstructive pelvic surgery: a randomized controlled trial. Obstet Gynecol. 2017;129(4):608-614. doi:10.1097/AOG.0000000000001940
4. American College of Obstetricians and Gynecologists/American Urogynecologic Society. Pelvic Organ Prolapse. ACOG Practice Bulletin No. 214. Obstet Gynecol. 2019;134(5):e126-e142. Reaffirmed 2024. doi:10.1097/AOG.0000000000003519