wileyonlinelibrary.com/journal/anzjog 119 © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
DOI: 10.1111/ajo.12720
ORIGINAL ARTICLE
A descriptive study on the efcacy and complications
of the Capio (Boston Scientifc) suturing device for
sacrospinous ligament fxation
Alex Mowat
1
, Vivien Wong
2
, Judith Goh
3
, Hannah Krause
3
, Anita Pelecanos
4
and
Peta Higgs
5
Aust N Z J Obstet Gynaecol 2018; 58: 119–124
1
Gynaecology Department, Royal
Brisbane and Women’s Hospital,
Brisbane, University of Queensland,
Queensland, Australia
2
Gynaecology Department, QEII
Hospital, Robina Hospital, Brisbane,
Queensland, Australia
3
Gynaecology Department, Greenslopes
Private Hospital, QEII Jubilee Hospital,
Coopers Plains, Queensland, Australia
4
Queensland Institute of Medical
Research, Brisbane, Queensland,
Australia
5
The Sunshine Coast Private
Hospital, Nambour General Hospital,
Nambour, Queensland, Australia
Correspondence: Dr Alex Mowat,
Royal Brisbane and Women’s Hospital,
University of Queensland, Queensland,
Australia.
Email: zanhmowat@gmail.com
Conficts of Interest: The authors report
no conficts of interest.
Received: 11 April 2017;
Accepted: 27 August 2017
Background: Sacrospinous colpopexy is an efective vaginal apical support op-
eration. Due to morbidity associated with traditional approaches which require
wide dissection, slim-line suture delivery devices have been introduced in the
hope of reducing morbidity without compromise to outcomes.
Aim: The aim of our series was to report outcomes and complications (particu-
larly buttock pain and blood loss) of the sacrospinous colpopexy using the Capio
suturing device and evaluate it against published results using the Miya hook.
Methods: This is a prospective, multi-centre descriptive study. The primary out-
come is objective success at 12 months. Secondary outcomes include subjective
success at 12 months, patient-reported outcomes at 12 months, operating time,
estimated blood loss and post-operative buttock pain.
Results: Fifty-one consenting patients undergoing sacrospinous colpopexy were
recruited at four Queensland hospitals. Objective success at 12 months was 95%
(41/43) and subjective success at 12 months was 92% (44/48). Eighty-four percent
of patients reported buttock pain at one week, reducing to 16% by six weeks, of
which 7% required analgesia.
Conclusions: At a mean of 17 months follow up, we found that the sacrospinous
colpopexy using the Capio suturing device provided excellent apical support with
a low requirement for blood transfusion and an average operating time of
seven minutes. We found a high rate of buttock pain immediately post-operatively,
but our rates became consistent with previous reports by six weeks
post-operation.
KEYWORDS
pain, postoperative, vaginal vault prolapse
INTRODUCTION
Vaginal vault prolapse is a common gynaecological complaint
with a rate of 6–12% post-hysterectomy.
1,2
In two-thirds of
these post-hysterectomy prolapses, there is multi-compartment
prolapse present
3
and it is now established that vault support
signifcantly improves the results of both anterior and posterior
wall reconstructive surgery, in terms of longevity of repair, reduc-
ing reoperation rates at 10 years from 20% to 11%.
4
Vault sup-
port can be achieved either via abdominal or vaginal techniques.
Commonly used abdominal procedures include sacral colpopexy,
and vaginal procedures include high uterosacral suspension and