Anchorsure® System
The Anchorsure® System (Neomedic International; distributed in the UK / Europe by JUNE Medical) is a PEEK anchor-based device (ABD) for sacrospinous ligament fixation (SSLF) in apical pelvic-organ-prolapse repair. Mechanistically distinct from suture-capturing devices like the Capio: rather than passing a suture through the ligament, the Anchorsure deploys a small biocompatible anchor into the sacrospinous ligament substance, with the apical-support suture pre-attached. Particularly suited to the anterior approach to the sacrospinous ligament, where suture-capturing devices are more technically demanding.[1][2]
Design
- Straight, narrow delivery device for atraumatic transvaginal introduction.
- PEEK (polyetheretherketone) anchor — 100% biocompatible polymer, permanently implanted.
- Pre-attached suture on the anchor.
- Tactile feedback during ligament engagement — signals correct anchor seating.
- Native-tissue (mesh-free) fixation system.[3]
Rationale — Anchor vs Suture Capture
Traditional suture-based SSLF requires tight suture knots around or through the ligament, which may:
- Compress or compromise neurovascular structures (pudendal nerve, inferior gluteal vessels)
- Contribute to gluteal / buttock pain — the characteristic SSLF complication
- Depend on ligament tissue quality to hold the knot long-term
The anchor-based approach embeds fixation within the ligament substance rather than encircling it — theoretically reducing the risk of neurovascular compression and related pain.
Reconstructive / Urogyn Uses
- Vaginal vault prolapse after hysterectomy — apical suspension
- Uterovaginal prolapse with sacrospinous fixation (Amreich–Richter technique)
- Post-hysterectomy vault prolapse repair
- Anterior approach to SSLF — the niche where Anchorsure's mechanical advantage over suture-capturing devices is largest[1]
Efficacy
| Endpoint | Result | Source |
|---|---|---|
| Sexual function at 3 mo (FSFI total score) | 19.15 → 21.84 (p < 0.05) in 115 women undergoing SSLS with Anchorsure | Ahmadian 2026 prospective multicenter[3] |
| Objective / subjective cure rates | 90–95% in 676-patient series (19 Anchorsure alone, remainder Anchorsure + transvaginal mesh) | Lo 2025[4] |
Complications
| Complication | Rate / Finding | Source |
|---|---|---|
| Day-1 postoperative pain | Slightly higher with ABD (3.40 vs 1.60 SCD, p = 0.013); mean highest pain score similar overall | Evangelopoulos 2024 pilot case-control (n = 40)[1] |
| Gluteal / posterior-thigh pain at 1 wk, 6 wk | No significant difference vs Capio | Plair 2022 RCT[2] |
| Opioid use postoperatively | Similar to Capio | Plair 2022 RCT[2] |
| Prolapse symptom scores | Similar to Capio | Plair 2022 RCT[2] |
| Tacker dislodgement | 2.2% of 676 cases; sequelae included 2 bladder injuries + 4 operator injuries (glove tears / finger cuts); higher BMI and HTN associated with dislodgement risk | Lo 2025[4] |
| Nerve-injury rate | Lower than Capio in pooled meta-analytic data | Amiri 2024 SR + meta-analysis[5] |
| Reoperation rate | Slightly higher than some suture-capturing devices; overall complication rates remain low across all devices | Amiri 2024 SR + meta-analysis[5] |
The Lo 2025 tacker-dislodgement signal is the most important contemporary caveat for surgeon technique: 2.2% dislodgement in a large cohort, with the operator-injury complication (glove tears / finger cuts) being a recurring theme. Two bladder injuries from dislodged anchors underscore the need for cystoscopy after deployment.
Anchorsure vs Capio — Head-to-Head Comparison
| Feature | Anchorsure (Anchor-Based) | Capio (Suture-Capturing) |
|---|---|---|
| Mechanism | Deploys anchor into SSL substance | Passes suture through SSL |
| Gluteal / posterior-thigh pain | No significant difference vs Capio[2] | No significant difference vs Anchorsure[2] |
| Day-1 postop pain | Slightly higher (3.40 vs 1.60)[1] | Slightly lower[1] |
| Nerve-injury rate | Lower than Capio[5] | Highest pooled rate (3.8%)[5] |
| Reoperation rate | Slightly higher[5] | Lower[5] |
| Anterior approach to SSL | Well-suited[1] | More technically challenging[1] |
| Device-specific failure mode | Tacker dislodgement 2.2% (Lo 2025)[4] | Pooled nerve-injury 3.8% (Amiri 2024)[5] |
The two devices are broadly equivalent for the primary outcomes (cure, gluteal pain) — the anterior-vs-posterior surgical approach and surgeon comfort drive most of the choice.[1][2]
Context Within POP Surgery
SSLF overall has slightly lower anatomical success than abdominal sacrocolpopexy (88% vs 91%) but offers shorter operative times, lower hemorrhage rates, and fewer GI complications — making it a durable native-tissue option for the patient who prefers a vaginal approach.[6] Within the SSLF instrument family, the choice between anchor-based (Anchorsure, Saffron) and suture-capturing (Capio, Endostitch, i-Stitch) devices is largely surgeon preference + approach geometry, since outcomes and complication profiles are broadly comparable.[1][2]
Regulatory / Commercial Status
- FDA-approved in the United States
- CE-marked in Europe
- Commonly distributed alongside the Uplift sacrocolpopexy mesh for laparoscopic prolapse repair (separate product family)
See also: Capio Suture Capturing Device, Saffron Fixation System, i-Stitch, Endostitch, Miya Hook, Deschamps Ligature Carrier.
References
1. Evangelopoulos N, Delacroix C, Abdirahman S, de Tayrac R. "Safety of an anchor-based device for sacrospinous ligament fixation: a pilot case-control study." Eur J Obstet Gynecol Reprod Biol. 2024;299:105–109. doi:10.1016/j.ejogrb.2024.06.012
2. Plair A, Smith W, Hines K, et al. "Gluteal and posterior thigh pain from a suture compared with an anchor-based device in patients undergoing sacrospinous ligament fixation: a randomized controlled trial." Obstet Gynecol. 2022;139(1):97–106. doi:10.1097/AOG.0000000000004629
3. Ahmadian N, Rastkar E, Amiri E, Bastani P, Sattarpour R. "Sexual function after Anchorsure repair of sacrospinous ligament suspension in patients with pelvic organ prolapse: a prospective multicenter study." Sci Rep. 2026. doi:10.1038/s41598-026-52719-w
4. Lo TS, Rellora LE, Yu CC, Ro AL, Yang CH. "Operator and patient injuries from tacker dislodgement during sacrospinous ligament fixation: a retrospective study." BJOG. 2025. doi:10.1111/1471-0528.70089
5. Amiri E, Bastani P, Mallah F, Mostafaei H, Salehi-Pourmehr H. "Comparison of the complications rate of different suture-passing techniques at the time of sacrospinous ligament fixation: a systematic review and meta-analysis." Arch Gynecol Obstet. 2024;310(6):2791–2809. doi:10.1007/s00404-024-07788-5
6. Zhang W, Cheon WC, Zhang L, et al. "Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis." Int Urogynecol J. 2022;33(1):3–13. doi:10.1007/s00192-021-04823-w