Vaginal sacrospinous ligament fixation with the Autosuture Endostitch device.
OBJECTIVE
The purpose of the study was to evaluate a disposable suturing device to facilitate vaginal sacrospinous ligament fixation.


METHODS
Seventeen consecutive patients (mean age 66.3 years) requiring vaginal sacrospinous ligament fixation had the procedure performed with the Autosuture Endostitch device with a braided polyester suture. Patients were evaluated with respect to operative time, blood loss, complications, hospital stay, and success of the vaginal fixation.


RESULTS
All patients underwent additional procedures, including anterior colporrhaphy (82.4%), posterior colporrhaphy (100%), vaginal hysterectomy (5.9%), enterocele repair (76.4%), and Burch suprapubic urethropexy (5.9%). The time required for the sacrospinous ligament pilcation ranged between 14 and 25 minutes (mean 18.8 +/- 3.0 minutes). Fifteen patients (88.2%) had an estimated blood loss < or = 100 ml for the complete procedure. No complications occurred. No patient was hospitalized > 4 days. Patients were followed up between 2 and 18 months (mean 9.8 +/- 4.2 months). Fifteen patients (88.2%) maintained good vaginal vault support. Two patients (11.8%) had recurrence at 4 and 6 months, respectively.


CONCLUSIONS
The Autosuture Endostitch device, although designed for endoscopic surgery, is efficacious for the performance of sacrospinous ligament fixation of the vaginal vault. Decreasing the length of the instrument would make it even more practical.
Schlesinger
R E
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Department of Obstetrics and Gynecology, St. Jude Medical Center, Fullerton, CA, USA.
D000368:Aged; D016063:Blood Loss, Surgical; D004867:Equipment Design; D004864:Equipment and Supplies / Q000592:standards*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008022:Ligaments / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011391:Prolapse; D013536:Suture Techniques / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000503:physiopathology / Q000601:surgery*; D014623:Vaginal Diseases / Q000601:surgery