Mesh Position Research Articles

A precise prediction of the tooth root stresses for involute external gears with any fillet geometry under consideration of the exact meshing condition

An environmentally friendly design of gearboxes means to increase the utilization of material steadily. This leads to in many ways optimized constructions, which require an exact prediction of occurring stresses under given load-carrying capacity to guarantee sufficient endurance. This paper shows a very precise method to calculate the occurring tooth root stress for involute, external gearings with any form of fillets within a few seconds. A two-dimensional Boundary–Element–Model is used to receive the notch stresses of the fillets which are linked to a high quality analytical tooth contact analysis to consider the exact relations of the gear meshing. The introduced model also allows a calculation of the occurring tension and compression stresses along the whole fillet for different meshing positions. This paper shows the optimization potential by using the described method in comparison to a standard approach.

Short-term comparison between preperitoneal and intraperitoneal onlay mesh placement in robotic ventral hernia repair.

The aim of this study was to compare perioperative results of robotic IPOM (r-IPOM) and robotic TAPP (r-TAPP) in ventral hernia repair, and to identify risk factors associated with postoperative complications. After obtaining balanced groups with propensity score matching, the comparative analysis was performed in terms of perioperative and early outcomes. All variables were also examined in a subset analysis in patients with and without complications. Multivariable regression analysis was used to identify independent risk factors associated with the development of complications. Of 305 r-IPOM and r-TAPP procedures, 104 patients were assigned to each group after propensity score matching. There was no difference in operative times between two groups. Although postoperative complications were largely minor (Clavien-Dindo grade-I and II), the rate of complications was higher in the r-IPOM group within the first 3-weeks (33.3% in r-IPOM vs. 20% in r-TAPP, p = 0.039). At the 3-month visit, outcomes between groups were not different (p = 0.413). Emergency department re-visits within 30-days and surgical site events were also higher in the IPOM group (p = 0.028, p = 0.042, respectively). In regression analysis, the development of complications was associated with incisional hernias (p = 0.040), intraperitoneal mesh position (p = 0.046) and longer procedure duration (p = 0.049). Our data suggest r-IPOM may be associated with increased complication rates in the immediate postoperative period when compared to r-TAPP. However, at 3 months, outcomes are comparable. More investigation is needed in this area, specifically with regards to long-term follow-up and multicenter data, to determine the true value of extra-peritoneal mesh placement.

New laparoendoscopic and minimally invasive extraperitoneal mesh augmentation techniques for ventral hernia repair

In recent years techniques for ventral hernia repair have undergone a dynamic evolution with the development of minimally invasive and laparoendoscopic techniques. Despite the multitude of methods, five main criteria for setting the target have emerged: 1)functional and morphological reconstruction of the abdominal wall, 2)extraperitoneal mesh augmentation, 3)abandonment of penetrating fixation elements, 4)minimal surgical access trauma of the abdominal wall and 5)minimized intraperitoneal dissection that jeopardizes adherent intestinal structures. The mesh position varies between preperitoneal retromuscular and supraneurotic or preaponeurotic on the anterior rectus sheath. The different approaches can be carried out transhernially or distant from the abdominal wall defect. The latter can be realized by laparoscopic transperitoneal, endoscopic subcutaneous and endoscopic retromuscular/preperitoneal approaches. Some techniques can be extended to anterior or posterior component separation to reduce tension and to enlarge the space for mesh placement. Robot-assisted surgery opens up new perspectives in laparoendoscopic abdominal wall surgery due to additional instrumental degrees of movement. This enables the possibility of preperitoneal ventral hernia operations also behind and lateral to the posterior rectus muscle compartments as was only previously known below the arcuate line from inguinal hernia surgery.

Non-linear modeling of gear drive dynamics incorporating intermittent tooth contact analysis and tooth eigenvibrations

In this paper the effect of the of individual tooth inertia on spur gear dynamics is investigated. A lumped element model is developed, in which tooth and gear inertial properties are decoupled, incorporating meshing position and load dependent meshing stiffness and backlash. A novel methodology for tooth contact analysis, which examines the instantaneous motion of individual teeth, completes the model. The dynamic response of a single-stage drivetrain is examined using both linear and non-linear analysis. Linear analysis demonstrates that, apart from tooth eigenfrequencies, high frequency coupled motion of gear tooth and gear hub DOFs occurs. Non-linear simulation is conducted for a range of operating conditions. Results show that tooth-inertia related vibration modes have noteworthy effects, especially in scenarios involving gears with low tooth numbers or low load. These include the presence of high frequency constituents in the dynamic transmission error, which promote contact loss and chaotic motion, without having a noticeable spectral signature in the transmission output and the reduction in the average number of contacting teeth at low loads, because of tooth eigenvibrations. These results indicate that modeling of individual tooth dynamics in the aforementioned scenarios is important.

Impact analysis and vibration reduction design of spiral bevel gears

To minimize the running vibration of spiral bevel gear, an optimization design method for vibration control is presented with the model of meshing impact. Firstly, based on the impact model of spiral bevel gears considering tooth deformation, the initial meshing position, meshing stiffness, and the meshing impact is studied. Secondly, the effects of load torque and rotation speed on meshing impact are analyzed. Thirdly, a mathematical model for pinion generator is built with following parameters: tool parameters, initial machine settings, and polynomial coefficients of auxiliary flank modification motion. The polynomial coefficients of the auxiliary flank modification motion are determined by optimizing the minimum impact velocity. Finally, a numerical simulation is performed. The results shows that load torque and pinion rotational speed impose significant influences on the impact. The impact velocity increases with the increase of load torque and pinion rotation speed. With load torque increasing, impact force tends to increase first and then decrease because of meshing stiffness changes, finally impact force increases dramatically due to additional load. The advantages of spiral bevel gear under the optimization of impact velocity in meshing impact are obviously. The accuracy and scientificity of the method presented in the paper for calculating the initial meshing point and meshing stiffness of complicated tooth surfaces is verified. The optimized gear obtained by the optimization method presented in the paper is also proved that owns the lowest meshing impact in the design load range. The proposed optimization method can reduce meshing impact and improve the dynamic meshing performance of spiral bevel gear. This method also can be used for optimum design of other types of gears.

Preclinical Investigation of a 2nd Generation DermaPort andtrade; Ported Vascular Access System (PVAS)

Introduction: The DermaPort™ Ported Vascular Access System (PVAS) was developed to improve central line access and reduce infections in hemodialysis while permitting catheter repositioning or replacement without disruption of the ingrown port. The PVAS port is comprised of a percutaneous titanium conduit with a subcutaneous titanium mesh ingrowth cuff and a disengageable silicone brake. Feedback from the clinical trial revealed that replacement of the peel away sheath (Gen1) with a dilating housing (Gen2) would be an improvement. Objective: Design and validate in vivo a Gen2 design that replaces the user-dependent peel away sheath. Methods: Three candidate housing designs and then three potential mesh cuff positions for the optimized Gen2 dilating housing without a sheath were screened in an acute porcine insertion model. These designs were compared to Gen1 with a sheath and a polyester-cuffed catheter. Next, the selected design and three potential mesh cuff positions were further tested in chronic 6-week and 4-week chronic rabbit studies, respectively. Both chronic studies histologically characterized mesh ingrowth and marsupialization in comparison to Gen1 and polyester-cuffed catheter controls. Results: Insertion of the Gen2 housing with a 10° dilating distal end was determined to be the most similar to Gen1 in the porcine model. The 4 and 6-week rabbit implant study showed a trend towards greater down growth for the deeper mesh designs and no observation of marsupialization. There were no significant differences in connective tissue ingrowth between the two PVAS housing designs or the mesh positions in the six week study, which was more mature and less inflammatory than in polyester-cuffed controls. Conclusions: These data provide support for the further development of the Gen2 PVAS in response to clinical feedback on the Gen1 design.t.

On Dynamic Mesh Force Evaluation of Spiral Bevel Gears

The mesh model and mesh stiffness representation are the two main factors affecting the calculation method and the results of the dynamic mesh force. Comparative studies considering the two factors are performed to explore appropriate approaches to estimate the dynamic meshing load on each contacting tooth flank of spiral bevel gears. First, a tooth pair mesh model is proposed to better describe the mesh characteristics of individual tooth pairs in contact. The mesh parameters including the mesh vector, transmission error, and mesh stiffness are compared with those of the extensively applied single‐point mesh model of a gear pair. Dynamic results from the proposed model indicate that it can reveal a more realistic and pronounced dynamic behavior of each engaged tooth pair. Second, dynamic mesh force calculations from three different approaches are compared to further investigate the effect of mesh stiffness representations. One method uses the mesh stiffness estimated by the commonly used average slope approach, the second method applies the mesh stiffness evaluated by the local slope approach, and the third approach utilizes a quasistatically defined interpolation function indexed by mesh deflection and mesh position.

Relationship between the engaging force of planetary gear train and the position‐correlated modal properties

Planetary gear train (PGT) is widely used in a variety of fields such as helicopters and aircraft engines. The failure of meshing gear often happens in the PGT due to the working condition of high speed, variable load, high-frequency excitation, assembly error etc. However, the causes of gear failure are still insufficiency, especially in the condition of high speed and high-frequency excitation. In this work, the engaging force between gear meshing pair of the PGT under high-frequency excitation is studied using the proposed position-correlated modal properties calculation method, which is established by incorporating the effect of meshing position and meshing phase difference of each contact pair into the free vibration model to study the modal properties of the PGT at different meshing positions. The corresponding engaging force responses based on the position-correlated modal properties are investigated. The simulation results show that the higher-order natural frequencies of the system are greatly affected by the meshing position. The peaks of engaging force occur at meshing positions where the natural frequencies are equal to the excitation frequency, which can be the potential cause of the gear damage.

Motion Periods of Planet Gear Fault Meshing Behavior.

Vibration sensors are, generally, fixed on the housing of planetary gearboxes for vibration monitoring. When a local fault occurred on the tooth of a planet gear, along with the system operating, the faulty tooth will mesh with the ring gear or sun gear at different positions referring to the fixed sensor. With consideration of the attenuation effect, the amplitudes of the fault-induced vibrations will be time-varying due to the time-varying transfer paths. These variations in signals are valuable information to identify the fault existence as well as the severity and types. However, the fault-meshing positions are time-varying and elusive due to the complicated kinematics or the compound motion behaviors of the internal rotating components. It is tough to accurately determine every fault meshing position though acquiring information from multi-sensors. However, there should exist some specific patterns of the fault meshing positions referring to the single sensor. To thoroughly investigate these motion patterns make effective fault diagnosis feasible merely by a single sensor. Unfortunately, so far few pieces of literature explicitly demonstrate these motion patterns in this regard. This article proposes a method to derive the motion periods of the fault-meshing positions with a faulty planet gear tooth, in which two conditions are considered: 1. The fault-meshing position initially occurs at the ring gear; 2. The fault-meshing position initially occurs at the sun gear. For each scenario, we derive the mathematical expression of the motion period in terms of rotational angles. These motion periods are, in essence, based on the teeth number of gears of a given planetary gearbox. Finally, the application of these motion periods for fault diagnosis is explored with experimental studies. The minimal required data length of a single sensor for effective fault diagnosis is revealed based on the motion periods.

Why we remove mesh.

As more mesh is implanted for hernia repairs, mesh-related complications may increase, with some requiring mesh removal. We describe our experience as to indications and perioperative factors that surround hernia mesh removal. All patients who underwent hernia mesh removal from the abdomen (ventral, flank) and pelvis (inguinal, femoral, obturator, perineal) were captured from a single hernia center database. Over 4.5years, we removed 105 mesh. Most were in males (58%), average age 53years, with average pain score 5/10. Males most commonly had mesh removed from the pelvis (65%), and females from the abdomen (63%, P = 0.009). Pain score was significantly higher prior to removal of hernia mesh from the pelvis (5.7 vs 4.5, P = 0.047). Type of mesh implanted and positioning of mesh showed no difference in pain (P > 0.05). Indications for hernia mesh removal significantly varied between the abdomen (infection, 43%) and the pelvis (pain, 91%, P < 0.0001). Mesh reaction became a more frequent indication for mesh removal in the pelvis, reaching 1/3 of patients by 2017. Most required general anesthesia (87%), with inpatient stay (53%, mode 1day). Open technique decreased with time (82-17%), laparoscopic decreased (20-10%), and robotic increased (0-70%). This is the largest and most comprehensive study detailing why we remove mesh. We provide awareness of indications and operative options to help guide physicians as they encounter patients who may require hernia mesh removal.

Parametric Studies of Mechanical Power Loss for Helical Gear Pair Using a Thermal Elastohydrodynamic Lubrication Model

In this study, a comprehensive mechanical efficiency model based on the thermal elastohydrodynamic lubrication (TEHL) is developed for a helical gear pair. The tribological performance of the helical gear pair is evaluated in terms of the average film thickness, friction coefficient, mechanical power loss, mechanical efficiency, etc. The influence of basic design parameters, working conditions, thermal effect, and surface roughness are studied under various transmission ratios. Results show that the contribution of thermal effect on the tribological performance is remarkable. Meanwhile, the rolling power loss constitutes an important portion of the total mechanical power loss, especially around the meshing position where the pitch point is located in the middle of contact line and the full elastohydrodynamic lubrication (EHL) state with the friction coefficient less than 0.005. The proper increase of normal pressure angle and number of tooth can improve the tribological performance. The influence of helix angle on the mechanical efficiency is less significant. A positive addendum modification coefficient for pinion and a negative addendum modification coefficient for wheel are good for improving the mechanical efficiency. The results provide the tribological guidance for design of a helical gear pair in engineering.

An Efficient Hybrid Analytical-Computational Method for Nonlinear Vibration of Spur Gear Pairs

This work develops a hybrid analytical-computational (HAC) method for nonlinear dynamic response in spur gear pairs. The formulation adopts a contact model developed in (Eritenel, T., and Parker, R. G., 2013, “Nonlinear Vibration of Gears With Tooth Surface Modifications,” ASME J. Vib. Acoust., 135(5), p. 051005) where the dynamic force at the mating gear teeth is determined from precalculated static results based on the instantaneous mesh deflection and position in the mesh cycle. The HAC method merges this calculation of the contact force based on an underlying finite element static analysis into a numerical integration of an analytical vibration model. The gear translational and rotational vibrations are calculated from a lumped-parameter analytical model where the crucial dynamic mesh force is calculated using a force-deflection function (FDF) that is generated from a series of static finite element analyses performed before the dynamic calculations. Incomplete tooth contact and partial contact loss are captured by the static finite element analyses and included in the FDF, as are tooth modifications. In contrast to typical lumped-parameter models elastic deformations of the gear teeth, including the tooth root strains and contact stresses, are calculated. Accelerating gears and transient situations can be analyzed. Comparisons with finite element calculations and available experiments validate the HAC model in predicting the dynamic response of spur gear pairs, including for resonant gear speeds when high amplitude vibrations are excited and contact loss occurs. The HAC model is five orders of magnitude faster than the underlying finite element code with almost no loss of accuracy.

A systemic analysis of patients undergoing open ventral hernia repair (2011-2017)

Background: The use of prosthetic mesh for reinforcing a hernia repair is considered most valid. Controversy exists regarding the use of the type of meshplasty. An insufficient evidence exists as to which type of mesh and mesh position (onlay, inlay, sublay (retrorectus) or preperitoneal) should be used. The effectiveness these methods have been systematically analysed in order to accelerate functional recovery and shorten hospitalization in patients undergoing open ventral hernia repair (VHR).Methods: This was a Prospective randomized single blinded comparative study conducted in the Department of Surgery at SMIMER hospital, Surat for patients presenting with the complaint of anterior abdominal wall hernia over a duration of 6 years (September 2011 - September 2017) with an average follow up period of 12 months, including 318 adult patients. All patients were preoperatively assessed clinically and by ultrasonography to confirm the diagnosis and randomized for open VHR after obtaining a well-informed written consent and satisfying the inclusion and exclusion criteria. 67% Patients (213/318) underwent retrorectus Meshplasty and were categorized into group A. The rest underwent Onlay (16.3% - 52/318)/Inlay (4.7% - 15/318)/Preperitoneal Meshplasty (11.9%-38/318) and were collectively (33% (105/318)) categorized into group B. Both Groups were Compared in terms differences in intra operative timing, intra operative complications, immediate post-operative outcome, early and delayed post- operative complications including readmission and recurrence rates.Results: Authors observed significantly lesser post-operative pain, higher well being, reduced wound complications and recurrence rate in group A. Mean duration of surgery was insignificantly higher for retrorectus meshplasty.Conclusions: Despite each method having its own advantages and disadvantages, retrorectus mesh repair was found superior because the mesh is placed with significant overlap under the muscular abdominal wall.

Synthetic Mesh for Large Ventral Hernia Repair Correlated with Evaluation of Quality-of-life A 5 years retrospective study

Ventral hernia mesh repair is considered a standard procedure in most countries and widely accepted as superior to primary suture repair. We conducted a 5 years retrospective observational study on large and giant incizional hernia repair in our Clinics. 176 consecutive patients who had a ventral hernia repair with mesh implant in 2012-2016 were evaluated in terms of demographic characteristics, comorbidities, surgical conditions (defect size, mesh type, positioning of the mesh, length of hospital) and surgical outcomes by means of EuraHS-QoL score pre- and 30 days postoperative to assess quality of life (Qol). Alloplastic substitution with polypropylene, polyester and Dacron mesh has been used in all cases. Polypropylene mesh has been used in most of cases (91%). Most preferred mesh position was intraperitoneal (78%), then retromuscular (15%) and preperitoneal (7%). Immediate postoperative complications appeared in 41 cases (23.3%). Mean hospital length was 14,3 days. We could notice a double pre- and postoperative difference for the pain, with statistical significance (2.71�1.70; p=0.23) and the same pattern of distribution for restriction of activities and for cosmetic discomfort.

Evaluating full-thickness skin grafts in intraperitoneal onlay mesh position versus onlay position in mice

BackgroundImportance: Hernia surgery requires reinforcement material with few side effects when used in the intraperitoneal position. Autologous skin grafting may meet this requirement, but animal experiments are obligatory before being applied in humans.Objective: To compare survival and effects of isogeneic full-thickness skin grafts in the intraperitoneal onlay mesh (IPOM) position in mice, with a control group using the onlay position. Primary end point was graft survival and secondary end point adhesion formation and inflammation through NF-κB activity. MethodsDesign: Intervention study with 8-week follow-up in accordance with ARRIVE criteria, performed between 2015 and 2016.Setting: Animal laboratory.Participants: Transgenic C57BL/6 mice with isogeneic background were used. Recipients were female wild-type phenotype mice >3 mo (n = 24). Donors were male or female mice >7 mo, with phenotype-positive for the luciferase gene (n = 20) or positive for NF-κB-luciferase gene (n = 4).Intervention: Full-thickness skin was grafted in the IPOM position and compared with grafts in the onlay position as controls. Survival was evaluated by regular longitudinal postoperative luminescence imaging over 8 wk. Adherence formation was evaluated macroscopically after sacrifice. Inflammation of full-thickness skin grafts in IPOM position of NF-κB mice was evaluated in four additional mice.Main outcome and measure: Survival of grafts, evaluated by luminescence. ResultsTen animals received grafts in the IPOM position, and 10 in the onlay position as controls. Graft survival after 8 wk was 100% (20/20). Average luminescence at the end of the 8-week period was 999,597 flux (min 162,800, max 2,521,530) in the IPOM group (n = 10) and 769,708 flux (min 76,590, max 2,164,080) in the onlay control group (n = 10). No adhesions requiring sharp dissection (Jenkins' scale >2) were seen. Four animals with grafts in the IPOM position showed peak inflammation (NF-κB activity) 5 d after surgery subsiding toward the end of follow-up. ConclusionsFull-thickness skin survives as well in the IPOM position as in the onlay control position, and few adherences develop. Further studies are required to fully characterize the tissue remodeling and repair processes associated with IPOM skin grafting. The result is relevant in the search for alternative reinforcement materials to be used in complex hernia surgery in humans.

Analysis of non-Hertz contact stress and bearing capacity on meshing pairs in a real-time non-clearance precision ball transmission

Considering the friction on meshing pairs in a real-time non-clearance precision ball transmission, a modified meshing mechanical analysis model was established, and the normal meshing force and tangential friction acting on each meshing pair were calculated accurately via the contact stiffness coefficient method. The ball–tooth contact was equivalent to the contact model of an ellipsoid and semi-infinite elastic solid according to non-Hertzian theory, and the contact stress of meshing pairs was analyzed by the discrete convolution and fast Fourier transform (DC-FFT) technique. Furthermore, the bearing-capacity estimation method for a transmission system was established based on the Mises yield criterion. The results show that the tangential distribution force has a significant effect on the contact stress field of a meshing pair, with the maximum Mises equivalent stress being approximately 0.621 times the central contact pressure at different meshing positions. Moreover, the bearing capacity of the planetary plate is weaker than that of the center plate; hence, the bearing capacity of a transmission system should be determined by the planetary plate.

Video-Assisted Mini-Open Sublay (VAMOS): A Simple Hybrid Approach for Lateral Incisional Hernias.

PurposeThe purpose is to present a new hybrid approach of lateral incisional hernia repair associated with reduced operative trauma and anatomically optimal mesh placement.MethodsVideo-Assisted Mini-Open Sublay (VAMOS) consists of a laparoscopic atraumatic dissection of the hernia sac, diaphanoscopy, laparoscopically-assisted closure of the fascial gap and mesh placement in sublay position through a minimized skin incision. Feasibility of this concept was assessed in a cohort of 7 consecutive patients.ResultsVAMOS approach was feasible in all 7 patients. Median hernia size was 8 cm, the median skin incision width was 7.7 cm. Median operative time was 86 min. In all patients a sufficient mesh overlap on all sides of the fascial gap was ensured. On short-term follow-up no procedure related complications were recorded, seroma formation occurred in 2 patients. Pain medication was necessary for median 4.9 days. There was no need for pain medication on day 14, whatsoever.ConclusionInitial VAMOS results show that the technique is simple, time-saving and safe. It provides a substantial reduction in postoperative pain compared to an open approach. Through implantation in the intermuscular sublay position and minor access-related trauma, it is possible to achieve a biomechanically optimal mesh position, to lay the foundations for adequate remodelling of the abdominal wall, and to prevent recurrence as well as local complications. All in all, VAMOS appears to have several advantages over current surgical strategies.

Tribological behavior of coated spur gear pairs with tooth surface roughness

Coating is an effective way to reduce friction and wear and to improve the contact-fatigue lives of gear components, which further guarantees a longer service life and better reliability of industrial machinery. The fact that the influence coefficient linking the tractions and stress components could not be expressed explicitly increases the difficulty of coated solids contact analysis. The complicated tribological behavior between tooth surfaces influenced by lubrication and surface roughness further adds difficulty to the coated gear pair contact problems. A numerical elastohydrodynamic lubricated (EHL) contact model of a coated gear pair is proposed by considering the coupled effects of gear kinematics, coating properties, lubrication, and surface roughness. The frequency response function and the discrete convolute, fast Fourier transformation (DC-FFT) method are combined to calculate the surface deformation and the subsurface stress fields at each meshing position along the line of action (LOA). The Ree-Eyring fluid is assumed to incorporate the non-Newtonian effect, which is represented in the generalized Reynolds equation. Influences of the ratio between the Young’s modulus of the coating and the substrate on the contact performance, such as pressure, film thickness, tooth friction coefficient, and subsurface stress field, are studied. The effect of the root mean square (RMS) value of the tooth surface roughness is studied by introducing the roughness data, deterministically measured by an optical profiler.

Thermomechanical coupled contact analysis of alternating meshing gear teeth surfaces for marine power rear transmission system considering thermal expansion deformation

Marine power rear transmission system is a constant power system under specific working condition, which relies on alternating meshing gears to transfer the movement and torque. It is difficult to accurately determine the actual thermal stress and thermal deformation for time-varying distribution using the traditional methods. Elastic structural mechanics modeling and method details of thermal expansion deformation are presented and analyzed. Both the actual reflection thermoelastic contact condition for meshing gears and the coupling effect results of the practical loading process of marine power rear transmission system carried out on alternating meshing gear surfaces are also detailed. In this article, the changes in gear meshing angles of several key meshing positions are presented. The 16 meshing positions of contact stresses and loaded deformation approach are analytically evaluated in terms of the rotation range of driving spur gear (35°) and driving helical gear (36°). The purpose of this study is to confirm the significant stress concentration areas of gear meshing in and meshing out and to obtain that the deformation amounts of gear meshing impact positions within selected zones. The aim of this article is to reach gear deformation on the basis of theoretical conception.

Robotic Single-Site Sacrocolpopexy with Retroperitoneal Tunneling.

Introduction:This series of cases was an investigation of the safety and feasibility of robotic laparoendoscopic single-site surgery (R-LESS) as a method of performing sacrocolpopexy.Case Presentation:This is a retrospective series of 15 cases of R-LESS sacrocolpopexy with the V-Loc (Medtronic, Minneapolis, Minnesota, USA) suture and a retroperitoneal tunneling technique performed by a single surgeon, combined with a literature review. Patient demographic information and perioperative data were analyzed. The standard robotic sacrocolpopexy steps were followed, but the surgeon used a combined technique of V-Loc suture and retroperitoneal tunneling to simplify the procedure. No additional ports were necessary in any of the patients.Management and Outcome:Using the pelvic organ prolapse quantification (POP–Q) scoring method, the mean preoperative C-point of the 15 patients was +1.16 compared to the mean immediate postoperative C-point, which was −5.5. The mean total sacrocolpopexy time was 74.7 (range, 50–99) minutes and mean mesh anchoring time was 22.60 ± 3.85 minutes. The mean sacral promontory fixation and tunneling and mesh position times were 11.87 ± 3.02 and 5.80 ± 2.14 minutes, respectively. All 15 cases were performed without perioperative or long-term complications.Discussion:R-LESS in combination with the V-Loc suture and the retroperitoneal tunneling technique can be safely and feasibly performed, especially in sacrocolpopexy and, potentially, in other POP surgeries. With adequate and systematic training, surgeons can acquire the necessary skills to perform this complex surgical procedure.