Current literature comparing laparoscopic (LSC) and robot-assisted sacrocolpopexy (RASC) for pelvic organ prolapse (POP) management is often limited by small cohort sizes. This study aimed to compare the efficacy and morbidity of LSC and RASC in a large cohort treated across three distinct medical specialties (Gynecology, Urology, and Digestive Surgery), and to evaluate practice variations among these departments.

We conducted a retrospective, single-center, multi-departmental study. The primary outcome was the overall reoperation rate for recurrence or complications. Secondary outcomes included intraoperative and postoperative complication rates, length of hospital stay, and 5-year recurrence-free survival.

The study included 266 patients (RASC, n = 201; LSC, n = 65) with a mean follow-up of 42.2 months. The overall reoperation rate did not differ significantly between the RASC (13.93%) and LSC (18.46%) groups ( p = 0.490). However, the LSC group experienced significantly higher rates of late minor postoperative complications (61.54%vs. 45.27%, p = 0.032) and constipation (43.08%vs. 25.87%, p = 0.013), as well as a longer median hospital stay (4 days vs. 3 days, p = 0.007). Inter-departmental analysis highlighted significant differences in concomitant surgical procedures, with the Gynecology department treating a significantly younger patient population.

RASC is a safe and reliable alternative to the conventional LSC approach for POP management. The choice of surgical approach should be guided by the surgeon's preference and expertise. Further prospective randomized trials are required to comprehensively evaluate all aspects of POP management.