Universal gynecological instrument for trans-obturator insertion of ligatures and tape-like implants in patients with pelvic organ prolapse
Authors:   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Ishchenko A.I. , Ishchenko A.A. ,   Treatment and Rehabilitation Center, Moscow, Russian Federation, Khokhlova I.D. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Dzhibladze T.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Gorbenko O.Yu. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Chushkov Yu.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Aleksandrov L.S. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Malyuta E.G. ,   Treatment and Rehabilitation Center, Moscow, Russian Federation, Siordia A.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Baburin D.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Komarova A.D. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Balyasin M.V. ,   Patrice Lumumba Peoples’ Friendship University of Russia (RUDN), Moscow, Russian Federation, Nogteva A.N. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Ganieva J.R. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: January 2025

Objective. To study the efficacy and safety of the original surgical instrument for trans-obturator insertion of ligatures and tapelike
implants in patients with pelvic organ prolapse (POP) and stress urinary incontinence (SIU).
Patients and methods. This study included 164 patients with POP and urethral hypermobility aged 34–79 years. The original threecomponent
surgical instrument for trans-obturator insertion of ligatures and tape-like implants (Patent No. 217079, 2022) was used during surgery. Four developed surgical programs using titanium mesh implants and non-absorbable ligatures were implemented.
Results. Patient questionnaire showed satisfaction with the results of surgical treatment in all cases, which had a positive effect on the quality of life, mood and contributed to an increase in social activity. Patients of reproductive age and in perimenopause reported an improved quality of sexual life. The recurrence of first-degree POP in the late postoperative period was diagnosed after 12–36 months in 5 patients (4.8%), but it did not require surgical re-intervention.
Conclusion. Clinical approbation of the developed three-component instrument for trans-obturator insertion of ligatures and tape-like implants in patients with different degrees of POP and SIU confirmed its effectiveness and safety. The undoubted advantages of this instrument include convenient assembly, simple postoperative processing and sterilization, as well as the possibility of multiple use and, therefore, economic benefit, which, together with other useful parameters, makes this instrument universal for this type of surgery.
Key words: gynecological surgical instrument, trans-obturator insertion of ligatures, tape-like implants