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

Objective To identify the factors contributing to tacker dislodgement and associated complications during sacrospinous ligament fixation (SSF) procedures. Design Retrospective study. Setting Tertiary medical center. Population 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. Methods 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. Main Outcome Measures Determine the occurrence of a tacker dislodge during application and the injury caused to the patient and the operator. Results 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. Conclusion 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.