The minimally invasive sacrospinous fixation under visual guidance: An anatomical study

• Published in: European journal of obstetrics & gynecology and reproductive biology 2024-06, Vol.297, p.36-39
• Main Authors: Chene, Gautier, Cerruto, Emanuele, Moret, Stephanie, Nohuz, Erdogan
• Format: Article
• Language: English
• Subjects: Aged; Anatomy; Cadaver; Female; Gynecologic Surgical Procedures - methods; Humans; Ligaments - anatomy & histology; Ligaments - surgery; Minimally Invasive Surgical Procedures - methods; Pelvic organ prolapse; Pelvic Organ Prolapse - surgery; Pudendal nerve; Sacrospinous fixation; Sacrospinous ligament; Sacrum - anatomy & histology; Sacrum - surgery; Suture Techniques; Vaginal vault prolapse
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2024.03.039

•An anatomical study with a new innovative minimally invasive technology using both a suture capturing device and a chip-on-the-tip endoscope to perform sacropinous fixation.•Postoperative complications have been described during sacrospinous fixation as hemorrhage, ischioanal hematoma, sciatic neuralgia, dyspareunia and chronic pain.•Identification of ischial spine and sacrospinous ligament as well as feasibility of sacrospinous fixation under NanoScope™ control.•This new vaginal minimally invasive technology could be an advantage in terms of safety and better placement of the suture during sacrospinous fixation. Sacrospinous fixation is the gold standard procedure for management of apical pelvic organ prolapse by the vaginal route. However, there may be a relevant risk of neurovascular injury due to the proximity of neurovascular structures. We propose an anatomical study concerning the sacrospinous ligament with a new innovative minimally invasive technology using both a suture capturing device and a chip-on-the-tip endoscope to perform sacropinous fixation. Study design: Bilateral sacrospinous fixation was performed in three female cadavers, in the course of the anatomical study conducted with a specific device (the Suture Capturing I Stitch™ Device) under real time visual guidance with a chip-on -the-tip endoscope, the NanoScope™ system. Identification of ischial spine and sacrospinous ligament as well as feasibility of sacrospinous fixation under NanoScope™ control were always possible on both sides. This new innovative minimally invasive technology using both a suture capturing device and a chip-on-the-tip endoscope is relevant and could be an advantage in terms of safety and better placement of the suture on the sacrospinous ligament.