ORIGINAL ARTICLE A randomized trial of vaginal mesh attachment techniques for minimally invasive sacrocolpopexy Jasmine Tan-Kim & Charles W. Nager & Cara L. Grimes & Karl M. Luber & Emily S. Lukacz & Heidi W. Brown & Kimberly L. Ferrante & Keisha Y. Dyer & Anna C. Kirby & Shawn A. Menefee Received: 10 September 2014 /Accepted: 4 November 2014 # The International Urogynecological Association 2014 Abstract Introduction and hypothesis We investigated the efficiency and efficacy of vaginal mesh attachment using interrupted, non-barbed, delayed absorbable sutures in comparison with a running, barbed, delayed absorbable suture during laparo- scopic sacrocolpopexy (LSC) and robotic sacrocolpopexy (RSC). Methods Women undergoing LSC or RSC were recruited. Participants were randomized to at least six 0 PDS non- barbed interrupted sutures or at least six passes of a 1 PDS barbed suture (Quill™) on each anterior and posterior polypropylene mesh leaflet. The primary outcome was the time to attach the mesh to the vagina. The LSC and RSC groups were block randomized by suture type. Secondary outcomes included: (1) intraoperative surgeon assessment of satisfaction as measured using a 10-cm visual analog scale (VAS), (2) postoperative POP-Q evaluation for anatomic fail- ure, and (3) overall appearance of vaginal walls measured using a VAS. Results Of the 64 included subjects who were randomized, 32 had mesh attachment with the barbed suture (16 LSC, 16 RSC) and 32 had attachment with non-barbed sutures (16 Registration with ClinicalTrials.gov 1. “Affixing Polypropylene Mesh Using Barbed Suture (Quill™ SRS) During Robotic Assisted Laparoscopic Sacrocolpopexy (Quill RALSC)”. ClinicalTrials.gov Identifier: NCT01608568 2. “Affixing Polypropylene Mesh Using Barbed Suture (Quill™ Srs) During Laparoscopic Sacrocolpopexy Randomized Controlled Trial (Quill Lsc) (QUILL-LSC)”. ClinicalTrials.gov Identifier: NCT01551992 Electronic supplementary material The online version of this article (doi:10.1007/s00192-014-2566-8) contains supplementary material, which is available to authorized users. J. Tan-Kim (*) : K. M. Luber : K. L. Ferrante : K. Y. Dyer : S. A. Menefee Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Ob/Gyn, Kaiser Permanente San Diego, 3250 Fordham St, San Diego, CA 92110, USA e-mail: jasmine.tankim@gmail.com C. W. Nager : E. S. Lukacz Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Reproductive Medicine, University of California, San Diego, La Jolla, CA, USA C. L. Grimes Division of Gynecologic Specialty Surgery, Department of Ob/Gyn, Columbia University Medical Center, New York, NY, USA H. W. Brown Division of Benign Gynecology and Gynecologic Specialties, Female Pelvic Medicine and Reconstructive Surgery Section, Department of Ob/Gyn, University of Wisconsin Medical Center, Madison, WI, USA K. L. Ferrante Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Ob/Gyn, University of California, San Diego, San Diego, CA, USA A. C. Kirby Division of Urogynecology, Department of Ob/Gyn, University of Washington Medical Center, Seattle, WA, USA Int Urogynecol J DOI 10.1007/s00192-014-2566-8