Dear Sir,I read the paper “Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse” by Chaturvedi et al.[1] with great interest. I congratulate the authors for presenting a reasonably large series of transvaginal pelvic reconstructive effort and have two observations.Instead of suture passer needles, I feel a tendon tunneler could be used. This comes in both straight and curved shapes and while the former can be used to pass the anterior limbs of the proline mesh around the bladder, the latter can be used to pass the posterior limbs around the rectum. Tendon tunnelers are round tipped and hence non-traumatic and can directly catch the limbs of the proline mesh, thus obviating the extra steps of first passing a thread with suture, then tying the suture to the mesh and subsequently pulling it.If mesh erosion still remains a potential complication, we can replace it with biological tissue. Fascia lata can be harvested in an endoscopy assisted manner and a similar template can be constructed with it using proline sutures. This will add a bit to the operating time but will further bring down the cost of this surgery.