Complications of three sacrospinous ligament fixation techniques.
OBJECTIVE
To compare the complications of three techniques used to pass the suture through the sacrospinous ligament when performing sacrospinous ligament fixation (SSLF): (1) the standard needle driver with direct visualization; (2) the Deschamps ligature carrier by palpation; and (3) the Miya hook ligature carrier by palpation.


METHODS
A retrospective chart review of 240 patients undergoing SSLF was performed. A standard needle driver with direct visualization was used for 46 patients; the Deschamps ligature carrier was used for 173, and the Miya hook for 21 patients. Intraoperative and postoperative complications were compared between the groups.


RESULTS
Twelve women (5%) had intraoperative and forty women (17%) had postoperative complications suspected directly from the suture placement. There was no statistically significant difference in the rate of total intraoperative complications among the three groups. The proportion of patients with postoperative complications that were felt to be directly related to the suture passage technique was significantly higher in the Deschamps group compared to the direct visualization group (18% vs 2%, P=0.002).


CONCLUSIONS
Passing the suture through the sacrospinous ligament under direct visualization may result in less intra and postoperative complications.
Pollak
J
J
Florida Center for Urogynecology, Hollywood, Florida, USA.
Takacs
P
P
Medina
C
C
D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007431:Intraoperative Complications; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012445:Sacrococcygeal Region / Q000601:surgery; D013536:Suture Techniques / Q000295:instrumentation*; D014596:Uterine Prolapse / Q000209:etiology / Q000601:surgery*; D014621:Vagina / Q000601:surgery