Operator and Patient Injuries From Tacker Dislodgement During Sacrospinous Ligament Fixation: A Retrospective Study.

Abstract

To identify the factors contributing to tacker dislodgement and associated complications during sacrospinous ligament fixation (SSF) procedures. Retrospective study. Tertiary medical center. Six hundred and seventy-six patients with stage ≥ 3 pelvic organ prolapse (POP) who underwent SSF with anchor-based devices (tackers) between April 2018 and November 2023. Of these, 657 underwent SSF with transvaginal mesh (Surelift: 463; Calistar-S: 194), and 19 underwent SSF with Anchorsure alone. Patients were grouped into secure (n = 649) and dislodged tacker (n = 27) groups. Standardised institutional protocols, included pre-operative assessments, validated Chinese questionnaires at baseline and follow-up at 6 and 12 months postoperatively. Determine the occurrence of a tacker dislodge during application and the injury caused to the patient and the operator. Tacker dislodgement occurred in 2.2% of the cases. The dislodged group had a significantly higher BMI (p < 0.001) and prevalence of hypertension (p = 0.004). Complications in this group included two bladder injuries and four operator injuries, including glove tears and finger cuts (p < 0.001). The secure group demonstrated significantly less blood loss than the non-secure group (p < 0.001). Objective and subjective cure rates were high and comparable between the groups: 95.5% and 94.4% for the secure group and 90% for the dislodged group. The quality of life and sexual function outcomes were similarly favourable. SSF using a tacker-based device was safe and effective. Recognising the risks associated with tacker dislodgement can enhance preparedness and minimise complications for both patients and operators.