Tendon Descensus Repair (TENDER) – A prospective clinical feasibility study of tendon transplantation for pelvic organ prolapse repair. (June 2020)

• Record Type: Journal Article
• Authors: Hornemann, Amadeus; Hoch, Benjamin; Hofmann, Jan; Franz, Wolfgang; Sütterlin, Marc
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 249(2020)
• Page Start: 37
• Page End: 41
• Publication Date: 2020-06
• Subjects: Descensus -- Cervicopexy -- Prolapse -- TENDER -- Pectopexy -- Pelvic organ prolapse -- Semitendinosus tendon autograft; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2020.04.035
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Objective: To show the feasibility of tendon transplantation for minimally invasive pectopexy in pelvic organ prolapse repair. Study design: Patients with uterine or vaginal vault prolapse (POP-Q point C Stage 2–4) were offered laparoscopic pectopexy by means of autologous semitendinosus tendon transplantation. This paper presents a case series and describes the technique regarding the first 10 patients who underwent surgery. After preparing the vagina or cervix for laparoscopic pectopexy a tendon of the patient's semitendinosus muscle was stripped and brought intraabdominally through the 10 mm trocar. The tendon was fixed between the cervix or vagina and to the pectineal ligaments on both sides of the pelvis. Results: All operations were performed successfully without complications. Vaginal examination demonstrated the intended elevation of the middle compartment. Mobility and power of the affected leg did not change. Recovery was fast, and discharge was possible between the second and third postoperative day. Conclusion: Our approach demonstrates the feasibility and safety of a laparoscopic pectopexy with a semitendinosus autograft instead of a synthetic mesh. The experience from orthopedic surgery shows that a semitendinosus tendon autograft is long-lasting and stable. In addition, the morbidity on the operated leg is low.