Capio / Capio SLIM Suture Capturing Device
The Capio™ (also marketed as Capio SLIM) is a single-use suture-capturing device manufactured by Boston Scientific for transvaginal pelvic-organ-prolapse (POP) repair. Its defining mechanic is a single-handed throw-catch-retrieve plunger motion that places and retrieves a suture across deep ligament tissue without requiring the wide pararectal dissection that traditional ligature carriers (Deschamps, Miya hook) demand. The dominant use is sacrospinous ligament fixation (SSLF) for apical prolapse; secondary uses include sacrospinous hysteropexy and vaginal paravaginal repair.[1][2][3][4]
Design
- Slim-line, single-use disposable shaft.
- Distal hook that catches the small curved needle on the opposite side of the target ligament after the plunger drives it through.
- Plunger trigger on the handle — one actuation = pass + capture in a single motion.
- Pre-loaded or manually loaded suture; compatible with both absorbable and permanent suture.[5]
- Capio SLIM = narrower-profile contemporary version for transvaginal apical POP work.
How It Works
- Device tip placed against the target ligament (sacrospinous, uterosacral, or arcus tendineus fascia pelvis).
- Plunger depression drives the small curved needle through the ligament.
- Hook on the opposite side captures the needle after pass-through.
- Release brings the needle and suture through to the catch side in a single motion — no separate retrieval step.
Reconstructive / Urogyn Uses
The dominant contemporary indications:
- Sacrospinous colpopexy (SSLF) for vaginal vault prolapse — the dominant use[1][3]
- Sacrospinous hysteropexy — uterine-sparing apical prolapse repair[6]
- Vaginal paravaginal repair for anterior compartment defects[4]
- Uterosacral ligament suspension (high uterosacral and Mayo-McCall variants)
- Iliococcygeus fixation and other deep-ligament pelvic suspensions
Efficacy
| Endpoint | Result | Source |
|---|---|---|
| Objective success at 1–3 yr | 86–95% | Mowat 2018; Leone Roberti Maggiore 2013[1][3] |
| Subjective success at 1–3 yr | 92–93% | Mowat 2018; Leone Roberti Maggiore 2013[1][3] |
| Recent confirmatory series (n = 163) | Effective, secure, low bleeding / vessel-injury / recurrence rates | Luffarelli 2025[2] |
| Absorbable vs permanent suture | Similar anatomic and subjective outcomes at 12 mo | Padoa 2023[5] |
Operative Advantages — Time and Blood Loss
Comparative data consistently favor Capio over traditional ligature-carrier techniques:
| Metric | Capio | Traditional | Source |
|---|---|---|---|
| Sacrospinous colpopexy OR time | 21 min | 39 min (p < 0.001) | Leone Roberti Maggiore 2013[3] |
| Total OR time (broader comparative series) | 86 min | 98 min | Luffarelli 2025[2] |
| Intraoperative blood loss | Reduced vs traditional | — | Leone Roberti Maggiore 2013[3] |
Complications
| Complication | Rate | Notes |
|---|---|---|
| Postoperative buttock pain at 1 wk | 84% | Universal early symptom in Mowat 2018[1] |
| Buttock pain at 6 wk | 16% | 7% requiring analgesia at 6 wk[1] |
| Gluteal / posterior-thigh pain vs anchor-based device (Anchorsure) | No significant difference | Plair 2022 RCT — informs but does not resolve the suture-vs-anchor debate[7] |
| Nerve-injury rate (suture-capturing devices, pooled) | 3.8% — highest among suture-capturing methods | Amiri 2024 SR + meta-analysis[8] |
| Blood transfusion / hematoma | Low | Mowat 2018; Amiri 2024[1][8] |
The Amiri 2024 nerve-injury signal is the most important contemporary caveat — the convenience of the throw-catch mechanic does not eliminate the proximity-to-pudendal-bundle risk inherent to any SSLF instrumentation, and the Capio has the highest pooled rate among the suture-capturing devices in that meta-analysis.[8]
Context Within POP Surgery
The Capio sits squarely within the native-tissue (mesh-free) vaginal prolapse repair paradigm, which remains a critical option alongside mesh-based vaginal repair and abdominal / robotic sacrocolpopexy. The Cochrane review of transvaginal repair modalities (Yeung 2024) frames the trade-offs across approaches; the Capio is one of several suture-passing instruments for SSLF, alongside the Deschamps ligature carrier, Miya hook, Anchorsure, Saffron fixation system, i-Stitch, and Endostitch.[6][9]
Capio vs Adjacent SSLF Devices
| Device | Mechanism | Key trade-off |
|---|---|---|
| Capio / Capio SLIM (Boston Scientific) | Suture-capturing throw-catch-retrieve | Shorter OR / less EBL; pooled nerve-injury 3.8% (Amiri 2024)[8] |
| Deschamps ligature carrier | Classic curved ligature-passing needle | Reusable, traditional; requires wider pararectal dissection |
| Miya hook | Curved suture-carrying needle | Historical workhorse; largely supplanted |
| Anchorsure (Neomedic / JUNE) | PEEK anchor in ligament substance | No through-pass; Plair 2022 RCT no pain difference vs Capio[7] |
| Saffron fixation system (Coloplast) | Anchor-based, two-piece reusable tool + single-use anchor | Newer anchor-based alternative |
| i-Stitch (A.M.I.) | Reusable, blunt ball-tipped suture, finger-guided | No sharp needle |
| Endostitch (Medtronic) | Laparoscopic automated suturing device | Repurposed for transvaginal SSLF |
See also: Miya Hook, Deschamps Ligature Carrier, Anchorsure, Saffron Fixation System, i-Stitch, Endostitch, Raz-Pereyra Trocar.
References
1. Mowat A, Wong V, Goh J, et al. "A descriptive study on the efficacy and complications of the Capio (Boston Scientific) suturing device for sacrospinous ligament fixation." Aust N Z J Obstet Gynaecol. 2018;58(1):119–124. doi:10.1111/ajo.12720
2. Luffarelli P, Sejfullai K, Mazzola C, et al. "Capio Slim suture capturing device for transvaginal apical pelvic organ prolapse." Eur J Obstet Gynecol Reprod Biol. 2025;310:113993. doi:10.1016/j.ejogrb.2025.113993
3. Leone Roberti Maggiore U, Alessandri F, Remorgida V, Venturini PL, Ferrero S. "Vaginal sacrospinous colpopexy using the Capio suture-capturing device versus traditional technique: feasibility and outcome." Arch Gynecol Obstet. 2013;287(2):267–74. doi:10.1007/s00404-012-2540-y
4. Leone Roberti Maggiore U, Ferrero S, Mancuso S, Costantini S. "Feasibility and outcome of vaginal paravaginal repair using the Capio suture-capturing device." Int Urogynecol J. 2012;23(3):341–7. doi:10.1007/s00192-011-1566-1
5. Padoa A, Ziv Y, Tsviban A, et al. "Permanent or absorbable suture material for sacrospinous ligament fixation: does it matter?" Eur J Obstet Gynecol Reprod Biol. 2023;283:112–117. doi:10.1016/j.ejogrb.2023.02.014
6. Lin FC, Gilleran JP, Powell CR, Atiemo HO. "To mesh or not mesh 'apical prolapse,' that is the question!" Neurourol Urodyn. 2024;43(7):1626–1630. doi:10.1002/nau.25469
7. 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
8. 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
9. Yeung E, Baessler K, Christmann-Schmid C, et al. "Transvaginal mesh or grafts or native tissue repair for vaginal prolapse." Cochrane Database Syst Rev. 2024;3:CD012079. doi:10.1002/14651858.CD012079.pub2