The suture fixation
Fixation to the sacrospinous ligament and suspension of the mesh is performed with the i-Stitch, an instrument for the safe, fast and minimally-invasive placement of sutures in hard-to-reach areas. The i-Stitch is designed for easy operation with just one hand.
Together with the i-Stitch, three different shapes and two sizes of mesh allow treatment of a wide range of pelvic floor defects. Level 1 support is created by a suspension suture connecting the apex of the InGYNious mesh – and therefore the apex of the vagina – with the sacrospinous ligament. For level 2 and level 3 support, labelled, colour-coded suture guides indicate at which points the mesh should be attached to the tendinous arch of pelvic fascia or muscular tissue. The correct fixation points vary, depending on which shape of mesh is being used.
To secure the mesh, the i-Stitch is inserted through the vagina – thus eliminating the need for “blind” tunnelling. This reduces the risk of intraoperative bleeding and trauma, and increases the patient’s chance of a speedy recovery. The instrument is available in two different models – one for penetration from above and the other with the tip rotated 180° to allow a comfortable approach from underneath. As with the suture guides, the i-Stitch suture material is colour-coded according to the different levels of support.