Vaginal sacrospinous ligament fixation with the Autosuture Endostitch device

The purpose of the study was to evaluate a disposable suturing device to facilitate vaginal sacrospinous ligament fixation.

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.

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.

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.