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Miya Hook

The Miya hook is a classic curved suture-carrying needle designed by Fumio Miya for sacrospinous ligament fixation (SSLF). Long, curved, and with a threaded eye at the tip, it carries suture through deep ligaments in a single pass. Along with the Deschamps carrier, it was the standard device for SSLF before contemporary automated suture-capture systems.

Design​

  • Long curved shaft (curve matches the sacrospinous-ligament approach angle)
  • Threaded eye at the tip — holds the suture for the pass
  • Reusable metal construction

How It's Used​

  1. Suture is threaded through the hook's eye
  2. The hook is advanced into the paravaginal space with two-finger palpation guiding the tip onto the sacrospinous ligament (typically 2 fingerbreadths medial to the ischial spine)
  3. The hook is driven through the ligament and back out
  4. The suture is disengaged from the hook on the far side and retrieved
  5. The hook is withdrawn, leaving the suture through the ligament

Contemporary Role​

Largely replaced by the Capio and similar automated suture-capturing devices that perform the throw-catch-retrieve maneuver in a single plunger motion. The Miya hook persists in:

  • Centers without Capio availability
  • Surgeons trained with the hook who prefer its tactile feedback
  • Teaching collections and historical reference

Safety Considerations​

A safety-comparison study found that — unlike the Capio family which remained fully within the sacrospinous ligament substance — the Miya hook and Deschamps carrier impinge upon but deflect posterior vessels (pudendal vessels, inferior gluteal) during the ligament pass. This impingement contributes to the higher bleeding risk historically associated with SSLF using traditional devices.

See also: Capio Suture Capturing Device, Deschamps Ligature Carrier, Bony Pelvic Anatomy, Pelvic Vascular Anatomy.