Implementation of Robotic-Assisted Sacrocervicopexy for Apical Organ Prolapse Using the Semitendinosus Tendon-Pilot Study and Analysis of Clinical Outcome.

Abstract

Introduction and hypothesis: This video demonstrates a robotic-assisted sacrocervicopexy using the semitendinosus tendon.

Methods: Between June 2022 and February 2023, we performed the worldwide first Da Vinci robotic-assisted sacrocervicopexies (SCP) for apical organ prolapse using the semitendinosus tendon of the left knee. Analysis of safety, feasibility, and clinical outcome of the first ten patients operated on using this new surgical technique included the German pelvic floor questionnaire (GPFQ) as well as a clinical examination.

Results: Ten patients with a follow-up of 12 months were included. There was a significant reduction of the patient's symptoms according to the GPFQ regarding the domain bladder (preoperatively versus 3 months postoperatively, mean 3.85 vs 1.61, p = 0.034), total score (preoperatively versus 3 months postoperatively, mean 12.79 vs 3.28, p = 0.034), and descensus symptoms (preoperatively versus 12 months postoperatively, mean 4.74 vs 0.67, p = 0.022). POP-Q stage (point C) was significantly reduced between the preoperative period and at the time of discharge (mean 2.2 vs 0, p = 0.004). No serious intra- and postoperative complications occurred.

Conclusions: This pilot study showed satisfying clinical outcomes after a follow-up of 12 months, with a low mid-term complication rate.