Abstract
Objective
To demonstrate the feasibility and the simplified surgical techniques of intraabdominal
suturing and knot–tying in robotic transvaginal natural orifice transluminal endoscopic
surgery (RV–NOTES) sacrocolpopexy.
Materials and Methods
We report on two patients with symptomatic stage II apical pelvic organ prolapse who
underwent a new technique of RV–NOTES sacrocolpopexy. Case one: A 69-year-old G2P2002
with a history of two prior vaginal deliveries presented with a vaginal bulge and
pressure symptoms. She was initially fitted for a pessary but was unsatisfied and
elected to proceed with surgical intervention. Case two: A 50-year-old G2P0011 female
with a history of one prior vacuum-assisted vaginal delivery presented with symptoms
of vaginal mass and bleeding due to an endometrial polyp. She was noted to have stage
2 apical prolapse and opted for transvaginal sacrocolpopexy.
Results
Both patients were observed overnight and discharged home twelve hours after surgery
on postoperative day 1, after completing a voiding trial. For both patients, the postoperative
course was unremarkable, and they only required one day of pain medications. At the
three–week follow–up visit, they endorsed no postoperative pain or complications,
and the POP-Q stage was noted to be 0. Patients had telemedicine visits at eight weeks
postoperatively, at which time they had returned to their regular activities and denied
symptoms of vaginal bulge or pressure.
Conclusion
Robotic assisted transvaginal NOTES sacrocolpopexy is a feasible and an alternative
to traditional laparoscopic NOTES sacrocolpopexy.
Keywords
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Article info
Publication history
Published online: March 25, 2021
Accepted:
March 16,
2021
Received:
February 18,
2021
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding support: None.
Author contribution: Dr. Juan Liu contributed equally to this work as first author.
Authors Listing: There are no persons who do not fulfill the requirements to be listed as authors.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
