Design: Case report and a surgical video

Setting: The patient was positioned in a modified lithotomy and robotic assisted laparoscopy was performed using the Xi Intuitive platform. First trocar was inserted in the umbilical scar, three 8 mm robotic trocars and one 5 mm assistant trocar were positioned in line at the level of the umbilicus.

Patients or Participants: KBPP, a 46 year old female with a past medical history of hypothyroidism and dyslipidemia presents with a feeling of a ball coming down her vagina and tenesmus. Her physical exam showed a vaginal vault prolapse and an enterocele.

Interventions: A laparoscopic robotic assisted sacrocolpopexy was indicated. During the cavitary inventory, the pelvic floor defect was evident and no other abdominal pathologies were found.

Measurements and Main Results: We considered that the patient had an effective surgical treatment for her pelvic organ prolapse. However, on the fourth day after surgery, she developed mesentery volvulus, and was submitted to laparoscopy for its correction.

Conclusion: Robotic assisted laparoscopy can be an excellent option for sacrocolpopexy, since it allows better access of challenging anatomic regions, shorter learning curves and more comfortable intra corporeal suture. It offers good anatomical and functional results with low morbidity, however, complications can happen. Mesenteric volvulus is a rare life threatening condition with few case reports in literature after minimally invasive sacrocolpopexy. Prompt recognition and emergency surgery are essencial for a good outcome