How to cite: Padmanabhan P. Pelvic Organ Prolapse Surgery: Robotic. Grand Rounds in Urology. February 2026. Accessed Oct 2026. https://grandroundsinurology.com/pelvic-organ-prolapse-surgery-robotic/
Summary
Priya Padmanabhan, MD, MPH, FACS, Professor of Urology and Fellowship Director, Urogynecology and Reconstructive Pelvic Surgery, Oakland University Beaumont School of Medicine, Royal Oak, Michigan, presents an overview of robotic abdominal surgery for pelvic organ prolapse. Dr. Padmanabhan emphasizes that the vaginal apex is central to pelvic support and describes the cardinal and uterosacral ligament complexes as key structures that maintain support for the uterus and vagina.
Dr. Padmanabhan reviews reasons for choosing an abdominal approach, including surgeon familiarity, preservation of vaginal length and depth, restoration of normal anatomy, the ability to use mesh to augment poor tissue quality, high patient satisfaction, early return to normal activities, and reduced pain with minimally invasive approaches. She divides abdominal prolapse repair into procedures performed with hysterectomy and procedures performed with uterine preservation.
Preoperative planning includes bowel function, sexual function, prior surgery, body image, patient choice regarding mesh and hysterectomy, and other individual factors. Dr. Padmanabhan discusses uterine preservation as an increasing option and notes short-term and early mid-term data showing no difference in reoperation rates, complications, or subjective and objective success compared with sacrocolpopexy with hysterectomy.
Dr. Padmanabhan identifies abdominal sacrocolpopexy as the gold standard repair with level one evidence supporting durability and efficacy. She explains that supracervical hysterectomy with sacrocolpopexy is associated with lower reoperation rates for mesh erosion than total hysterectomy. She also reviews abdominal uterosacral suspension as an option for apical repair without mesh.
About the 45th Annual Ralph E. Hopkins Urology Seminar
The Annual Ralph E. Hopkins Urology Seminar, also known as the Jackson Hole Seminars, brings together distinguished urologists, clinical researchers, and thought leaders to share wisdom and experience that drives meaningful progress in patient care. Changes occur in medicine and urology on an almost daily basis, so it is imperative that the practicing urologist remains on the cutting edge. Urologists need to keep current on assessing, diagnosing, and treating urologic conditions in the clinical setting. The 45th meeting took place in 2026, focusing on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, emerging surgical techniques, and general urology. 2026 also marked the meeting’s first-ever all-female speaker panel.
ABOUT THE AUTHOR
Priya Padmanabhan, MD, MPH, FACS, is a Professor of Urology and Fellowship Director of Urogynecology and Reconstructive Pelvic Surgery at the Oakland University Beaumont School of Medicine in Royal Oak, Michigan. Her clinical interests include women’s health, complex incontinence, female urology, pelvic prolapse and reconstruction, robotics, and neuromodulation.
