The Use of Robotic Technology in Female Pelvic Floor Reconstruction Jennifer T

The Use of Robotic Technology in Female Pelvic Floor Reconstruction Jennifer T. Anger • Karyn S. Eilber Editors

The Use of Robotic Technology in Female Pelvic Floor Reconstruction Editors Jennifer T. Anger Karyn S. Eilber Department of Surgery, Division Department of Surgery, Division of of Urology Urology Cedars-Sinai Medical Center Cedars-Sinai Medical Center Beverly Hills, CA, USA Beverly Hills, CA, USA

ISBN 978-3-319-59610-5 ISBN 978-3-319-59611-2 (eBook) DOI 10.1007/978-3-319-59611-2

Library of Congress Control Number: 2017946483

© Springer International Publishing AG 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Foreword

In the last decade surgeons have advanced minimally invasive approaches to abdominal and pelvic surgery, utilizing both standard laparoscopy and robotic technology to improve the scope of possibilities. The rapid adoption of robotic techniques has afforded the female pelvic surgeon a broader armamentarium to pelvic floor reconstruction, with a specific aim of offering our patient population a more durable and efficacious approach to pelvic floor repairs. This comprehensive textbook of robotic technology applied to female pelvic reconstruction is the first of its kind and will be a valuable educational tool for surgeons. Numerous prolific female pelvic surgeons with both urological and gynecological backgrounds have contributed to this text, covering all aspects of patient selection, optimization of robotic techniques, and pitfalls. Additionally, options for management of the uterus at the time of prolapse repair will be dis- cussed. This topic has become more critical as more of our patients inquire about less invasive approaches. This surgical textbook encompasses the spectrum of pelvic floor disease and a unique approach to reconstructive techniques. It should serve as an educational tool for the surgeon-in-training as well as the experienced female pelvic surgeon seeking to expand his/her armamentarium for reconstruction.

NYU Langone Medical Center Nirit Rosenblum, M.D. New York, NY, USA

v Preface

Welcome to the textbook, The Use of Robotic Technology in Female Pelvic Floor Reconstruction. The fields of urology and urogynecology, now collec- tively termed Female Pelvic Medicine and Reconstructive Surgery, have rap- idly evolved over time. Surgeons adopt new technology with the ultimate goal of providing better care for patients. Robotic surgery is a technological advancement that provides durability through a minimally invasive approach. Outcomes are comparable to laparoscopic surgery. Since robotic technology allows surgeons without laparoscopic training to perform good laparoscopy, we anticipate that the use of the robot in FPMRS will only increase. This textbook is designed to provide guidance for surgeons wishing to perform the most common robotic procedures in FPMRS. We first seek to teach robotic surgery to readers with a background in FPMRS but not in robotics. We were once in that place, experiencing the frustrations of a begin- ner learning a new technology, despite fellowship training and expertise with other approaches. We also wish to reach out to non-FPMRS surgeons, specifically urologists adept at robotic prostatectomy, who may be able to techni- cally perform the steps of a robotic ASC, yet may not know certain nuances. Such nuances, which include when to place a prophylactic sling and when to perform a concomitant posterior vaginal wall repair, have a significant impact on postoperative outcomes. And lastly, we seek to reach out to anyone in training, either before, during, or after residency, who seek to learn more about robotic technology in FPMRS. We wish to thank each author in this textbook, each of whom has specific expertise in the field and provides a wealth of information. Dr. Amy Rosenman, Past President of the American Urogynecologic Society, has years of experience treating prolapse bother surgically and nonsurgically and provides an excellent review on patient candidacy for surgery. Drs. Una Lee and Arianna Smith each provide detailed explanations addressing concomitant surgeries and when they should and should not be performed. Thank you to Drs. Kim Kenton, M. Jonathon Solnik, and Christopher Tarnay, all gyne- cologists by training, not only for your chapters, but especially for your will- ingness to train us (urologists) and make us proficient in robotic hysterectomy. Drs. David Magner and Beth Moore have taught us a great deal about the role of robotic technology in combined rectal and vaginal prolapse. Dr. Bilal Chughtai provides a comprehensive synthesis of the literature addressing uterine sparing approaches robotically. And lastly, our own colleagues at Cedars-Sinai Medical Center, Drs. Hyung Kim, Christopher Dru, and Devin

vii viii Preface

Patel, who demonstrate how to apply robotic technology to robotic reconstructive procedures other than sacrocolpopexy. Thank you to Springer Publishing Company for the support and inspiration to write this book, and a special thanks to Miss Elise Paxson, who has helped us so patiently in putting all the pieces of this book together. We are also grateful to each other for patiently assisting as we each climbed, and ulti- mately passed, our individual learning curves in robotic surgery. We dedicate this textbook to the Anger family (Lowell, Arielle, Amanda, and Joshua) and the Eilber family (Fritz, Dylan, Parker, and Alexandra), who understand the sacrifices that the two of us make on a daily basis to be wives, mothers, and surgeons. We are indebted, grateful, and, because of your support, tireless.

Beverly Hills, CA, USA Jennifer T. Anger, M.D., M.P.H. Karyn S. Eilber, M.D. Contents

1 Introduction...... 1 Jennifer T. Anger and Karyn S. Eilber 2 Patient Selection, Risks, and Alternative Surgical Strategies...... 5 Jessica S. Zigman and Amy E. Rosenman 3 Selection of Concomitant Vaginal Procedures...... 21 Sarah A. Adelstein and Una J. Lee 4 Concomitant Management of Occult and Symptomatic Stress Urinary Incontinence...... 37 Steven J. Weissbart and Ariana L. Smith 5 Set-Up for Robotic Sacrocolpopexy...... 53 Katarzyna Bochenska and Sarah Collins 6 Steps of Robotic-Assisted Sacrocolpopexy...... 63 Karyn S. Eilber and Juzar Jamnagerwalla 7 Robotic-Assisted Hysterectomy with Abdominal Sacrocolpopexy...... 73 Janine L. Oliver and Christopher M. Tarnay 8 The Role of Power Morcellation and Controversies...... 91 A. Lenore Ackerman 9 Sacrohysteropexy...... 107 Bilal Chughtai and Dominique Thomas 10 Additional Gynecologic Indications for Robotic-Assisted Surgery...... 115 M. Jonathon Solnik and Lea Luketic 11 Robotic Surgical Management of Combined Vaginal and Rectal Prolapse...... 127 Emily Siegel, Beth A. Moore, and David P. Magner 12 Enterocele...... 137 David P. Magner, Adam Truong, and Beth A. Moore

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13 Robotic-Assisted Vesicovaginal Fistula Repair...... 149 Devin Patel and Jennifer T. Anger 14 Robotic-Assisted Ureteral Reimplantation...... 159 Christopher J. Dru and Hyung L. Kim 15 Complications of Robotic Urologic Surgery...... 167 Kathleen C. Kobashi

Index...... 175 Contributors

A. Lenore Ackerman, M.D., Ph.D. Department of Surgery, Department of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, USA Sarah A. Adelstein, M.D. Section of Urology and Renal Transplantation, Virginia Mason, Seattle, WA, USA Jennifer T. Anger, M.D., M.P.H. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, USA Katarzyna Bochenska, M.D. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University, Prentice Women’s Hospital, Chicago, IL, USA Bilal Chughtai, M.D. Department of Urology, Weill Cornell Medicine/ New-York Presbyterian, New York, NY, USA Sarah Collins, M.D. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University, Prentice Women’s Hospital, Chicago, Illinois, USA Christopher J. Dru, M.D. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA Karyn S. Eilber, M.D. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, USA Juzar Jamnagerwalla, M.D. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, USA Hyung L. Kim, M.D. Department of Surgery, Division of Urology, Cedars- Sinai Medical Center, Los Angeles, CA, USA Kathleen C. Kobashi, M.D., F.A.C.S. Virginia Mason Medical Center, Seattle, WA, USA Una J. Lee, M.D. Section of Urology and Renal Transplantation, Virginia Mason, Seattle, WA, USA Lea Luketic, M.Sc., M.D. Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON, Canada

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David P. Magner, M.D., F.A.C.S. Department of Surgery, Division of Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA Beth A. Moore, M.D., F.A.C.S., F.A.S.C.R.S. Department of Surgery, Division of Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA Janine L. Oliver, M.D. Division of Urology, Department of Surgery, University of Colorado Hospital, Aurora, CO, USA Devin Patel, M.D., M.B.A. Department of Surgery, Division of Urology, Cedars Sinai Medical Center, Los Angeles, CA, USA Amy E. Rosenman, M.D. David Geffen School of Medicine, University of California at Los Angeles, Santa Monica, CA, USA Emily Siegel, M.D. Department of Surgery, Division of Colorectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA Ariana L. Smith, M.D. Department of Surgery, Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA M. Jonathon Solnik, M.D., F.A.C.O.G., F.A.C.S. University of Toronto Faculty of Medicine, Mount Sinai Hospital, Toronto, ON, Canada Christopher M. Tarnay, M.D. Department of Obstetrics & Gynecology; Urology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA Dominique Thomas, B.S. Department of Urology, Weill Cornell Medicine/ New-York Presbyterian, New York, NY, USA Adam Truong, M.D. Department of Surgery, Division of Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA Steven J. Weissbart, M.D. Department of Urology, Stony Brook University, Stony Brook, NY, USA Jessica S. Zigman, M.D. Female Pelvic Medicine and Reconstructive Surgery Fellow, Harbor UCLA Medical Center, Torrance, CA, USA Abbreviations

ACCESS Abdominal colpopexy: comparison of endoscopic surgical strategies AH Abdominal hysterectomy ASC Abdominal sacral colpopexy or abdominal sacrocolpopexy ASH Abdominal sacrohysteropexy AUB Abnormal uterine bleeding BMI Body mass index BS Bilateral salpingectomy CARE Colpopexy and urinary reduction efforts CRADI Colorectal-Anal Distress Inventory EEA End-to-end anastomosis EBL Estimated blood loss EQ5D EuroQol five dimensions questionnaire FDG Fluorodeoxyglucose FSFI Female Sexual Function Index HLRCC Hereditary leiomyomatosis and renal cell cancer HNPCC Hereditary nonpolyposis colorectal cancer HPF High-power field HPV Human papillomavirus ICIQ-VS International Consultation on Incontinence Questionnaire of vaginal symptoms ICS International Continence Society ISD Intrinsic sphincter deficiency IVF In vitro fertilization LASC Laparoscopic sacrocolpopexy LDH Lactate dehydrogenase LMH Laparoscopic mesh sacrohysteropexy LSC Laparoscopic sacrocolpopexy LSH Laparoscopic suture sacrohysteropexy MAUDE Manufacturer and User Facility Device Experience database MIS Minimally invasive surgery MRI Magnetic resonance imaging MTR Microscopic tubal reanastomosis NNT Number needed to treat OPUS Outcomes following vaginal prolapse repair and midurethral sling

xiii xiv Abbreviations

OR Odds ratio PCOS Polycystic ovarian syndrome PEG Polyethylene glycol PET Positron emission tomography PFD Pelvic floor disorder PFDI Pelvic Floor Distress Inventory PFDN PELVIC Floor Disorders Network POP Pelvic organ prolapse POP-Q Pelvic organ prolapse quantification POPDI-6 Pelvic Organ Prolapse Distress Inventory 6 PTFE Polytetrafluoroethylene QOL Quality of life RASC Robotic-assisted sacrocolpopexy RALH Robotic-assisted laparoscopic hysterectomy RALM Robotic-assisted laparoscopic myomectomy RALS Robotic-assisted laparoscopic sacrohysteropexy RASC Robotic-assisted sacrocolpopexy RCC Renal cell carcinoma SRH Supracervical robotic hysterectomy SSLF Sacrospinous ligament fixation SUI Stress urinary incontinence TLH Total laparoscopic hysterectomy TRH Total robotic hysterectomy TOMUS Trial of midurethral slings ULMS Uterine leiomyosarcoma US FDA US Food and Drug Administration USLS Uterosacral ligament suspension VCUG Voiding cystourethrogram VVF Vesicovaginal fistula