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Related Experiment Video

Updated: Jul 8, 2026

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Episcissors-60 in Obstetrics Anal Sphincter Injury (OASI): A Systematic Review and Meta-Analysis.

Wesam Hammouri1,2, Victoria Kershaw3, Aethele Khunda3

  • 1Division of Urogynaecology, Department of Obstetrics and Gynaecology, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK. wesam.hammouri@nhs.net.

International Urogynecology Journal
|July 7, 2026
PubMed
Summary

Episcissors-60 may reduce obstetric anal sphincter injuries (OASI) in all vaginal deliveries, but not specifically in episiotomy cases. Further research is needed to confirm its effectiveness in preventing OASI.

Keywords:
Episcissors-60EpisiotomyOASIObstetric anal sphincter injury

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Innovation
  • Patient Safety

Background:

  • Obstetric anal sphincter injury (OASI) is a significant concern in childbirth.
  • Episiotomy can minimize OASI, but its appropriate use is key.
  • Episcissors-60 were developed to enhance mediolateral episiotomy accuracy.

Purpose of the Study:

  • To systematically review and evaluate the efficacy of Episcissors-60 in preventing OASI.
  • To address the National Institute of Health and Care Excellence's (NICE) recommendation for research on Episcissors-60's OASI prevention capabilities.

Main Methods:

  • Systematic review and meta-analysis registered with Prospero-University of York.
  • Literature search conducted across MEDLINE, EMBASE, and CINAHL databases up to August 2023, with an update in March 2025.
  • Included studies featured comparator groups (historic or parallel) and were screened per PRISMA protocol by two independent reviewers.

Main Results:

  • Eight studies (2 randomized, 6 observational) were included; 6 were high-quality.
  • A significant reduction in OASI rate was observed in the total number of vaginal deliveries (RD -0.02, 95% CI[-0.04, -0.01]).
  • No significant difference was found in OASI rate for episiotomy deliveries (RD -0.02, 95% CI[-0.05, 0.00]) or episiotomy rate (RD 0.01, 95% CI[-0.02, 0.04]).

Conclusions:

  • Episcissors-60 showed a protective effect in overall vaginal deliveries but not specifically in episiotomy deliveries.
  • The observed effect may be influenced by a Hawthorne effect.
  • An adequately powered randomized controlled trial (RCT) is warranted to accurately assess Episcissors-60's efficacy in OASI prevention.