Tips/Tricks Presentations: AUGS Abstracts: 2005 26th Annual Scientific Meeting of The American Urogynecologic Society
To demonstrate how stay sutures offer advantages over stay hooks found in the Lone Star Retractor System.
The Lone Star Retractor System (Lone Star Medical Products, Inc., Stafford, TX) is commonly employed during perineal and vaginal procedures. It includes a ring, providing a frame around an incision, and elastic stay hooks, allowing tissues about the incision to be secured to the ring. Although available in various forms, the stay hooks may be less suitable than stay sutures, especially when tissues to be retracted lay deep within the vagina.
During several vaginal procedures, wherein retraction of deep mucosal surfaces was critical, stay sutures, rather than stay hooks, were used to secure those surfaces to the ring of the Lone Star Retractor System. The first case involved repair of a vesicovaginal fistula that had developed after vaginal hysterectomy. The fistula opened into the apical vagina, just anterior to hyterectomy scar. The second case involved surgical management of obstructive uropathy following 4-corner colposuspension and vaginal wall sling. The urethra and bladder neck were found to be elevated and fixed. Mobilization of these structures was performed, allowing them to descend and providing them mobility. Midurethral sling then was positioned.
Stay sutures offer advantages over stay hooks found in the Lone Star Retractor System. The sutures are inexpensive. They are easily and reliably secured to tissues found deep within the vagina and existing there under tension. After placement, they do not leave behind a sharp surface within the operative field.