These findings have implications for the selleck screening library organization of health care delivery of both minimally invasive and open procedures. Table 8 ICD-9 codes for index diagnosis. Table 9 Postoperative procedure-specific complications.Pelvic organ prolapse is a very common problem that causes an estimated one in ten women to undergo surgery, and an additional 30% of these women will undergo additional surgery for repeat prolapse [1]. As the population of the United States continues to age, the number of women seeking treatment for pelvic organ prolapse will only continue to grow. The goal of surgical repair of all vaginal vault prolapse is to restore the anatomy and maintain sexual function and durability [2].

While the gold standard for vaginal vault prolapse is an abdominal sacrocolpopexy, large advances have been made in technology to allow minimally invasive approaches to become a viable alternative for surgeons [3]. Additionally, patients are also requesting a minimally invasive approach for their surgery because of the shorter hospital stay, decreased postoperative pain, and better cosmesis [4]. Initially, laparoscopy was offered to patients as a mode of performing a minimally invasive sacrocolpopexy. While patients have a decreased morbidity compared to traditional open approaches, there are notable difficulties experienced by the surgeon [3, 5]. Decreased range of motion, two-dimensional vision, and a steep learning curve are some of the many factors that have led to the increased operative time associated with laparoscopic surgery and have limited its widespread adoption by many surgeons.

An increased skill level is also required to perform laparoscopic suturing, which is made difficult by the limited range of motion of the laparoscopic instruments [5]. More recently, the Da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) has provided the features needed to make the minimally invasive sacrocolpopexies successful [6]. The robot offers three-dimensional vision, increased magnification, tremor filtering, and seven degrees of freedom with its instruments that make a robotic-assisted sacrocolpopexy less difficult than using a traditional laparoscope. The technical aspects of a RASCP reflect those of an abdominal sacrocolpopexy [7].

As the RASCP becomes more widely adopted into practice, the importance of training the next generation of practitioners becomes apparent without neglecting gaining experience in the traditional abdominal and vaginal hysterectomy concomitant with sacrocolpopexy [8]. Robotic surgery credentials are Batimastat now required in certain places and in the near future it will be required more widely [9]. The training of residents and fellows on the technique of RASCP is important in both urology [10] and gynecology [11].