Archives of Gynecology and Obstetrics

, Volume 287, Issue 2, pp 267–274

Vaginal sacrospinous colpopexy using the Capio suture-capturing device versus traditional technique: feasibility and outcome

  • Umberto Leone Roberti Maggiore
  • Franco Alessandri
  • Valentino Remorgida
  • Pier Luigi Venturini
  • Simone Ferrero
General Gynecology

Abstract

Purpose

This study compares the feasibility and outcome of sacrospinous colpopexy for treating vaginal vault prolapse (VVP) performed by either the traditional technique or a simplified procedure using the Capio™ suture-capturing device.

Materials and methods

Eighty-six patients with VVP were included in the study. Forty-two patients were treated by traditional sacrospinous colpopexy (TSC group) and 44 patients were treated by the modified technique using the Capio device (CSC group). Additional procedures were performed to restore concomitant pelvic floor defects.

Results

The mean (±SD) total operative time was significantly lower in the CSC group (71.7 ± 24.5 min) than in the TSC group (105.5 ± 31.5 min; p < 0.001); the intraoperative blood loss was higher in the TSC group than in the CSC group. In the CSC group, the mean operative time required to perform sacrospinous colpopexy was 21.4 ± 3.2 min. In patients who underwent only sacrospinous colpopexy, the time required to perform surgery was significantly lower in the CSC group (20.9 ± 3.3 min) than in the TSC group (39.1 ± 5.2 min; p < 0.001). There was no significant difference in the incidence of surgical complications between the two study groups. The objective and subjective success rates at 3-year follow-up were 88.1 and 92.9 % in the TSC group while in the CSC group they were 86.4 and 92.9 %.

Conclusion

The modified technique of sacrospinous ligament fixation using the Capio device reduces the operative time and blood loss when compared to the traditional technique.

Keywords

Capio device Operative time Sacrospinous ligament colpopexy Sacrospinous ligament fixation Vaginal vault prolapse 

References

  1. 1.
    Keshavarz H, Hillis SD, Kieke BA, Marchbanks PA (2002) Hysterectomy surveillance—United States, 1994–1999. MMWR Surveill Summ 51:1–8Google Scholar
  2. 2.
    Mant J, Painter R, Vessey M (1997) Epidemiology of genital prolapse: observations from the Oxford family planning association study. BJOG 104:579–585CrossRefGoogle Scholar
  3. 3.
    Toozs-Hobson P, Boos K, Cardozo L (1998) Management of vaginal vault prolapse. Br J Obstet Gynaecol 105:13–17PubMedCrossRefGoogle Scholar
  4. 4.
    Marchionni M, Bracco GL, Checcucci V et al (1999) True incidence of vaginal vault prolapse: thirteen years of experience. J Reprod Med 44:679–684PubMedGoogle Scholar
  5. 5.
    Barrington JW, Edwards G (2000) Posthysterectomy vault prolapse. Int Urogynecol J Pelvic Floor Dysfunct 11:241–245PubMedCrossRefGoogle Scholar
  6. 6.
    Dällenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M (2008) Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct 19:1623–1629PubMedCrossRefGoogle Scholar
  7. 7.
    DeLancey JO (2005) The hidden epidemic of pelvic floor dysfunction: achievable goals for improved prevention and treatment. Am J Obstet Gynecol 192:1488–1495PubMedCrossRefGoogle Scholar
  8. 8.
    Swift SE (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 183:277–285PubMedCrossRefGoogle Scholar
  9. 9.
    Richter K (1968) Die chirurgische Anatomie der Vaginae.fixatio sacrospinalis vaginalis: ein Beitrag zur operativen Behandlung des Scheidenblindsack prolapses. Geburtshilfe Frauenheilkd 28:321–327PubMedGoogle Scholar
  10. 10.
    Kearney R, DeLancey JOL (2003) Selecting suspension points and excising the vagina during Michigan fourwall sacrospinous suspension. Obstet Gynecol 101:325–330PubMedCrossRefGoogle Scholar
  11. 11.
    Wang Y, Wang D, Li Y, Liang Z, Xu H (2011) Laparoscopic sacrospinous ligament fixation for uterovaginal prolapse: experience with 93 cases. Int Urogynecol J Pelvic Floor Dysfunct 22:83–89CrossRefGoogle Scholar
  12. 12.
    Nichols DH (1982) Sacrospinous fixation for massive eversion of the vagina. Am J Obstet Gynecol 142:901–904PubMedGoogle Scholar
  13. 13.
    Morley GW, DeLancey JO (1988) Sacrospinous ligament fixation for eversion of the vagina. Am J Obstet Gynecol 158:872–881PubMedGoogle Scholar
  14. 14.
    Carey MP, Slack MC (1994) Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse. Br J Obstet Gynaecol 101:536–540PubMedCrossRefGoogle Scholar
  15. 15.
    Hardiman PJ, Drutz HP (1996) Sacrospinous vault suspension and abdominal colposacropexy: success rates and complications. Am J Obstet Gynecol 175:612–616PubMedCrossRefGoogle Scholar
  16. 16.
    Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR (1996) Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol 175:1423–1431PubMedCrossRefGoogle Scholar
  17. 17.
    Meschia M, Bruschi F, Amicarelli F, Pifarotti P, Marchini M, Crosignani PG (1999) The sacrospinous vaginal vault suspension: critical analysis of outcomes. Int Urogynecol J Pelvic Floor Dysfunct 10:155–159PubMedCrossRefGoogle Scholar
  18. 18.
    Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ (2004) Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol 190:20–26PubMedCrossRefGoogle Scholar
  19. 19.
    Aigmueller T, Riss P, Dungl A, Bauer H (2008) Long-term follow-up after vaginal sacrospinous fixation: patient satisfaction, anatomical results and quality of life. Int Urogynecol J Pelvic Floor Dysfunct 19:965–969PubMedCrossRefGoogle Scholar
  20. 20.
    Srikrishna S, Robinson D, Cardozo L (2010) Validation of the Patient Global Impression of Improvement (PGI-I) for urogenital prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21:523–528CrossRefGoogle Scholar
  21. 21.
    Maroto JR, Gorraiz MO, Bueno JJ, Pérez LG, Bru JJ, Chaparro LP (2009) Transobturator adjustable tape (TOA) permits to correct postoperatively the tension applied in stress incontinence surgery. Int Urogynecol J Pelvic Floor Dysfunct 20:797–805PubMedCrossRefGoogle Scholar
  22. 22.
    Petri E, Ashok K (2011) Sacrospinous vaginal fixation-current status. Acta Obstet Gynecol Scand 90:429–436PubMedCrossRefGoogle Scholar
  23. 23.
    Ouzaid I, Rhouma SB, de Tayrac R, Costa P, Prudhomme M, Delmas V (2010) Mini-invasive posterior sacrospinous ligament fixation using the CAPIO needle driver: an anatomical study. Prog Urol 20:515–519PubMedCrossRefGoogle Scholar
  24. 24.
    Schlesinger RE (1997) Vaginal sacrospinous ligament fixation with the Autosuture Endostitch device. Am J Obstet Gynecol 176:1358–1362PubMedCrossRefGoogle Scholar
  25. 25.
    Lind LR, Choe J, Bhatia NN (1997) An in-line suturing device to simplify sacrospinous vaginal vault suspension. Obstet Gynecol 89:129–132PubMedCrossRefGoogle Scholar
  26. 26.
    Veronikis DK, Nichols DH (1997) Ligature carrier specifically designed for transvaginal sacrospinous colpopexy. Obstet Gynecol 89:478–481PubMedCrossRefGoogle Scholar
  27. 27.
    Chou LY, Chang DY, Sheu BC, Huang SC, Chen SY, Chang WC (2010) Clinical outcome of transvaginal sacrospinous fixation with the Veronikis ligature carrier in genital prolapse. Eur J Obstet Gynecol Reprod Biol 152:108–110PubMedCrossRefGoogle Scholar
  28. 28.
    Leone Roberti Maggiore U, Ferrero S, Mancuso S, Costantini S (2012) Feasibility and outcome of vaginal paravaginal repair using the Capio suture-capturing device. Int Urogynecol J 23:341–347PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Umberto Leone Roberti Maggiore
    • 1
  • Franco Alessandri
    • 1
  • Valentino Remorgida
    • 1
  • Pier Luigi Venturini
    • 1
  • Simone Ferrero
    • 1
  1. 1.Department of Obstetrics and GynecologySan Martino Hospital and National Institute for Cancer Research, University of GenoaGenoaItaly

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