Robotic-Assisted Cervical Suspension Using Autologous Tendon Shows Promise for Uterine Prolapse

Uterine prolapse, a condition in which the uterus descends from its normal position, affects nearly half of all women over the course of their lives, according to recent estimates. This condition, particularly in its severe forms, can cause significant physical discomfort and psychological distress. While synthetic mesh implants and hysterectomy are common treatments, researchers at the University Hospital Bonn (UKB) have developed a minimally invasive, robotic-assisted procedure that uses a patient’s own tendon to address the condition. This innovative approach offers new hope for women with advanced uterine prolapse.

Autologous Tissue and Robotic Precision: A Novel Technique

In June 2022, the UKB team performed the world’s first robotic-assisted cervical suspension procedure using autologous tendon harvested from the posterior thigh. Unlike synthetic mesh, this technique avoids introducing foreign material into the body, thereby reducing the risk of complications. Additionally, the tendon extraction has no long-term effects on the leg’s mobility or functionality, ensuring patients maintain full use of their limb after surgery.

Robotic assistance plays a crucial role in enhancing the precision of this procedure. The system’s highly magnified 3D visualization enables surgeons to operate with exceptional accuracy, minimizing tissue trauma and blood loss. According to Prof. Dr. Dominique Könsgen-Mustea, Head of Urogynecology at the UKB, this approach allows for optimal access to the pelvic floor's deep compartments, where conventional surgical techniques often fall short.

To assess the technique’s effectiveness, the UKB team conducted a pilot study involving 10 patients between June 2022 and February 2023. The team evaluated both objective and subjective patient outcomes at three and twelve months post-surgery.

Positive Outcomes and Future Directions

Results from the pilot study, recently published in the International Urogynecology Journal, revealed excellent clinical outcomes. None of the patients experienced a recurrence of prolapse within the first year after the procedure, and no intraoperative or postoperative complications were reported. Patients also noted significant improvements in quality of life, with high satisfaction rates regarding the surgical results.

“This pilot study shows excellent clinical outcomes, with an improved quality of life for the patients,” explained Prof. Könsgen-Mustea. The minimally invasive nature of the robotic-assisted procedure makes it a promising option for women with severe prolapse, she added.

Looking ahead, the UKB has established an international research network to further evaluate the technique’s long-term outcomes. This collaboration aims to expand the use of the procedure while ensuring consistent and effective results across different clinical settings.

Why It Matters

The robotic-assisted cervical suspension technique marks a significant advancement in urogynecological care. By eliminating the need for synthetic mesh and preserving the uterus, it addresses a critical gap in treatment options for uterine prolapse. Importantly, the procedure aligns with the preferences of many women to retain their reproductive organs, offering a more patient-centered alternative to hysterectomy.

For healthcare professionals, this innovative approach provides a safe, minimally invasive solution for a condition that is both physically and emotionally taxing for patients. With promising early outcomes and ongoing international collaboration, this procedure could pave the way for a new standard of care in managing advanced uterine prolapse.