# Tele-Robotic Pectopexy Across Cities Using an Indigenous Robotic Platform: A Case Report

## TL;DR

This case report demonstrates the successful use of a local robotic system for remote gynecological surgery in India, showing it can overcome geographic barriers to specialized care.

## Contribution

The first reported case of tele-robotic pectopexy in India using an indigenous robotic platform, demonstrating its feasibility and safety.

## Key findings

- Tele-robotic pectopexy was performed successfully over a long distance with stable communication and no intraoperative complications.
- The patient had an uneventful recovery and showed improved pelvic anatomy and quality of life at three months.
- The procedure highlights the potential of tele-robotic surgery to expand access to advanced gynecologic care in resource-limited settings.

## Abstract

Tele-robotic surgery enables surgeons to operate from distant locations using robotic platforms and secure communication networks, helping reduce geographic barriers to specialized surgical care. Its application in gynaecologic pelvic reconstructive surgery is still limited, particularly in low- and middle-income countries. We present a case demonstrating the feasibility of long-distance tele-robotic pectopexy in India.

A 57-year-old woman with third-degree uterovaginal prolapse, third-degree cystocele, and first-degree rectocele underwent tele-robotic pectopexy at Her Health Hospital, Bhopal, using the SSI Mantra 3.0 Surgical Robotic System (SS Innovations International Inc., Gurugram, India). The patient was under general anaesthesia in Bhopal, while the primary surgeon operated remotely from Agra via the SSI Mantra tele-surgery platform. The telecommunication link remained stable throughout the procedure, providing real-time instrument control and clear visualization. Robot docking time was seven minutes, and total console time was 92 minutes. Estimated blood loss was approximately 50 mL, with no intraoperative complications.

The postoperative recovery was uneventful, and the patient was discharged on postoperative day two. At the three-month follow-up, she was asymptomatic with restored pelvic anatomy and improved quality of life. This case highlights that long-distance tele-robotic pectopexy is safe, feasible, and effective, with the potential to expand access to advanced gynaecologic care in resource-limited settings.