Innovative vaginal manipulator technique vs. traditional method for vaginal fornix deployment in robotic sacrocolpopexy.

Introduction and hypothesis: Pelvic organ prolapse (POP) affects approximately 30% of middle-aged and older women, with 11%-19% requiring surgical intervention. Laparoscopic sacrocolpopexy preserves the vaginal axis and length but involves a steep learning curve and longer operation times. Robotic sacrocolpopexy (RSC) addresses these issues, offering enhanced surgical precision. This study aimed to evaluate the feasibility and effectiveness of a novel vaginal manipulator (Hoyte Sacro Tip®; Cooper Surgical, Trumbull, CT, USA) compared with the traditional spatula in RSC. Methods: This retrospective cohort study included 88 females undergoing RSC at Kawasaki Medical School Hospital between January 2021 and December 2023. Patients were divided into two groups: spatula ( Results: Baseline characteristics were similar between the groups, except for gravidity and hypertension, which were higher in the spatula group than that in the vaginal manipulator group. No significant differences were found in operative time, console time, estimated blood loss, or complication rates between the groups ( Conclusions: The vaginal manipulator proved to be a safe and feasible alternative to the traditional spatula, with comparable perioperative outcomes and shorter hospital stays. The manipulator's design facilitated better tissue dissection, potentially improving surgical efficiency.