Comparison of the complications rate of different suture-passing techniques at the time of sacrospinous ligament fixation: a systematic review and meta-analysis

This study was designed to assess the complications raised in different suture-passing techniques when fixating the Sacrospinous ligament for pelvic organ prolapse (POP). We searched PubMed, Embase, Scopus, Web of Sciences, ProQuest, Google Scholar, and Cochrane Library, and performed a systematic review meta-analysis to assess complications when implementing different suture passings in fixating the sacrospinous ligament. The inclusion and exclusion criteria for literature screening were predetermined to allow for a more rigorous process. Interventions should include sacrospinous fixation (SSF) as a point of attachment for POP. To eliminate confounding bias and effect modification, at least one arm must include SSLF without mesh or graft. The primary endpoint used was the need for reoperation, nerve injury, hematoma, and the need for blood transfusion. The secondary endpoint was study screening. For eligible articles, data were extracted and summarized independently by two reviewers. The systemic review used the data from 125 studies, including 10,216 cases. The reoperation rate was 1.2% overall, with higher rates in the Shutt Suture Punch System, Laurus, and Anchorsure. The nerve injury rate was 3.8%, with Capio having the highest rate. The hematoma rate was 1.7%, with Laurus and Raz anchoring showing higher rates. Blood transfusion rates were higher with Modified Deschamps and Deschamps devices. Complications related to suture passing are increased when suture capturing is the method applied in passing the suture through the sacrospinous ligament.