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Updated: Dec 13, 2025
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Vaginal cuff perforation during robotic-assisted mesh recto-sacrocolpopexy
Jacqueline Chavez1, Carlos Finsterbusch1, Craig Olson1
1UT Southwestern Medical Center Dallas Texas USA.
Introduction:
We report on the management of intraoperative vaginal cuff perforation during robotic-assisted mesh recto-sacrocolpopexy for vaginal vault prolapse with defecatory dysfunction.
Case Presentation:
A 75-year-old woman with vaginal bulge and constipation was to undergo a joint robotic mesh recto-sacrocolpopexy. Intraoperatively, mesh was secured to the left posterior vaginal wall following dissection. Prior to contralateral suture placement, the vaginal cuff split open and exposed an end-to-end anastomotic sizer previously inserted in the vagina. Due to subsequent mesh erosion risk, we proceeded with vaginotomy closure with running and interrupted absorbable sutures, removal of mesh, direct suture rectopexy to the promontory, and enterocele defect correction by reapproximating the right and left wings of the peritoneum flaps over the rectum with running sutures. Patient reported satisfactory outcomes after 2 years.
Conclusion:
We reviewed our experience with vaginal cuff perforation during robotic-assisted mesh recto-sacrocolpopexy prompting enterocele repair and rectopexy without mesh.
