Da Vinci Single-Port Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Sacrocolpopexy: A Case Report and Literature Review

Pelvic organ prolapse remains a common condition requiring durable surgical correction, with sacrocolpopexy considered the gold standard. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as a scarless minimally invasive approach, while the integration of robotic single-port technology may further enhance surgical precision and ergonomics. However, data on robotic-assisted single-port vNOTES (RSP-vNOTES) sacrocolpopexy remains limited. We report a case of a 58-year-old Asian woman with symptomatic apical pelvic organ prolapse. The pelvic organ prolapse quantification (POP-Q) assessment demonstrated stage II uterine prolapse. She underwent robotic-assisted single-port vNOTES (RSP-vNOTES) sacrocolpopexy using the da Vinci single-port (SP) platform. The procedure was successfully completed via a transvaginal approach without abdominal incisions. Operative time was 170 min, with minimal blood loss (25 mL), and no intraoperative complications occurred, nor was a conversion required. The patient was discharged on postoperative day two and demonstrated an uneventful recovery with sustained anatomical support at one-year follow-up. This case highlights the feasibility and safety of RSP-vNOTES sacrocolpopexy and underscores its potential advantages, including enhanced visualization, improved instrument dexterity, and the benefits of a scarless approach. As an early application of RSP-vNOTES in pelvic reconstructive surgery, this technique may represent a significant advancement in minimally invasive management of pelvic organ prolapse. Therefore, this case report aimed to describe the surgical technique and perioperative outcomes of RSP-vNOTES sacrocolpopexy using the da Vinci SP platform, while highlighting its potential advantages and clinical relevance. By presenting this early experience, we seek to contribute to the evolving evidence base and inform future adoption of this innovative approach in minimally invasive pelvic reconstructive surgery.