Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report

Abstract Background The management of pelvic organ prolapse remains a clinical challenge, particularly with concerns regarding the safety of synthetic mesh-based procedures. In response, we present a novel approach for apical prolapse repair utilizing robotic assistance for tendon transplantation, o...

Full description

Saved in:
Bibliographic Details
Main Authors: Dominique Koensgen, Charlotte Lukannek, Carolin Schroeder, Lucia A. Otten, Amadeus Hornemann, Alexander Mustea
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-025-05267-2
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849688284942303232
author Dominique Koensgen
Charlotte Lukannek
Carolin Schroeder
Lucia A. Otten
Amadeus Hornemann
Alexander Mustea
author_facet Dominique Koensgen
Charlotte Lukannek
Carolin Schroeder
Lucia A. Otten
Amadeus Hornemann
Alexander Mustea
author_sort Dominique Koensgen
collection DOAJ
description Abstract Background The management of pelvic organ prolapse remains a clinical challenge, particularly with concerns regarding the safety of synthetic mesh-based procedures. In response, we present a novel approach for apical prolapse repair utilizing robotic assistance for tendon transplantation, offering a promising alternative to the use of synthetic meshes. Case presentation A 47-year-old multiparous woman (white, non-Hispanic) with a history of three vaginal deliveries and laparoscopic supracervical hysterectomy presented with symptoms of pelvic organ prolapse, including vaginal discomfort, recurrent urinary tract infections, and overactive bladder. Clinical examination and ultrasonography revealed a combined anterior and apical vaginal prolapse grade II according to the Pelvic Organ Prolapse Quantification system. A robotic sacrocervicopexy with a semitendinosus autograft, harvested from the left popliteal fossa, and concomitant anterior colporrhaphy were performed. The surgical procedure included the dissection of the ligamentum longitudinale using a nerve-sparing technique, cervix preparation, and tendon transplantation. The surgery lasted 172 min without intraoperative complications. The patient’s postoperative recovery was swift without residual prolapse, voiding dysfunction, or urinary incontinence reported at any of the follow-up examinations, conducted at 8 weeks, 3 months, 6 months, and 1 year after the operation. Conclusion This case report demonstrates the successful application of a robotic-assisted tendon transplantation approach for apical prolapse repair, offering a safe and effective alternative to synthetic mesh-based surgical procedures. An ongoing multicenter registry study aims to further validate the method’s safety and efficacy, paving the way for its broader adoption in clinical practice.
format Article
id doaj-art-3112df2c166e4e949b230d4db15b2c20
institution DOAJ
issn 1752-1947
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series Journal of Medical Case Reports
spelling doaj-art-3112df2c166e4e949b230d4db15b2c202025-08-20T03:22:03ZengBMCJournal of Medical Case Reports1752-19472025-05-011911410.1186/s13256-025-05267-2Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case reportDominique Koensgen0Charlotte Lukannek1Carolin Schroeder2Lucia A. Otten3Amadeus Hornemann4Alexander Mustea5Department of Gynecology and Gynecological Oncology, University Hospital BonnDepartment of Gynecology and Gynecological Oncology, University Hospital BonnDepartment of Gynecology and Gynecological Oncology, University Hospital BonnDepartment of Gynecology and Gynecological Oncology, University Hospital BonnDepartment of Gynecology, BürgerspitalDepartment of Gynecology and Gynecological Oncology, University Hospital BonnAbstract Background The management of pelvic organ prolapse remains a clinical challenge, particularly with concerns regarding the safety of synthetic mesh-based procedures. In response, we present a novel approach for apical prolapse repair utilizing robotic assistance for tendon transplantation, offering a promising alternative to the use of synthetic meshes. Case presentation A 47-year-old multiparous woman (white, non-Hispanic) with a history of three vaginal deliveries and laparoscopic supracervical hysterectomy presented with symptoms of pelvic organ prolapse, including vaginal discomfort, recurrent urinary tract infections, and overactive bladder. Clinical examination and ultrasonography revealed a combined anterior and apical vaginal prolapse grade II according to the Pelvic Organ Prolapse Quantification system. A robotic sacrocervicopexy with a semitendinosus autograft, harvested from the left popliteal fossa, and concomitant anterior colporrhaphy were performed. The surgical procedure included the dissection of the ligamentum longitudinale using a nerve-sparing technique, cervix preparation, and tendon transplantation. The surgery lasted 172 min without intraoperative complications. The patient’s postoperative recovery was swift without residual prolapse, voiding dysfunction, or urinary incontinence reported at any of the follow-up examinations, conducted at 8 weeks, 3 months, 6 months, and 1 year after the operation. Conclusion This case report demonstrates the successful application of a robotic-assisted tendon transplantation approach for apical prolapse repair, offering a safe and effective alternative to synthetic mesh-based surgical procedures. An ongoing multicenter registry study aims to further validate the method’s safety and efficacy, paving the way for its broader adoption in clinical practice.https://doi.org/10.1186/s13256-025-05267-2Apical prolapse surgeryTendon transplantationRobotic-assisted surgeryCase reportPelvic organ prolapseSynthetic mesh
spellingShingle Dominique Koensgen
Charlotte Lukannek
Carolin Schroeder
Lucia A. Otten
Amadeus Hornemann
Alexander Mustea
Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report
Journal of Medical Case Reports
Apical prolapse surgery
Tendon transplantation
Robotic-assisted surgery
Case report
Pelvic organ prolapse
Synthetic mesh
title Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report
title_full Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report
title_fullStr Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report
title_full_unstemmed Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report
title_short Robotic-assisted tendon transplantation—approach for pelvic organ prolapse repair: a case report
title_sort robotic assisted tendon transplantation approach for pelvic organ prolapse repair a case report
topic Apical prolapse surgery
Tendon transplantation
Robotic-assisted surgery
Case report
Pelvic organ prolapse
Synthetic mesh
url https://doi.org/10.1186/s13256-025-05267-2
work_keys_str_mv AT dominiquekoensgen roboticassistedtendontransplantationapproachforpelvicorganprolapserepairacasereport
AT charlottelukannek roboticassistedtendontransplantationapproachforpelvicorganprolapserepairacasereport
AT carolinschroeder roboticassistedtendontransplantationapproachforpelvicorganprolapserepairacasereport
AT luciaaotten roboticassistedtendontransplantationapproachforpelvicorganprolapserepairacasereport
AT amadeushornemann roboticassistedtendontransplantationapproachforpelvicorganprolapserepairacasereport
AT alexandermustea roboticassistedtendontransplantationapproachforpelvicorganprolapserepairacasereport