Perigee and Apogee system
The Perigee and Apogee system was the first system to use the approach of the infracoccygeal sacropexy to deploy a larger mesh over an entire compartment (ie anterior compartment for cystoceles and posterior compartment for rectoceles). The device is available in either a monofilament polypropylene mesh or a biologic porcine graft. Since the advantage of polypropylene versus biologic graft has not yet been established, the choice of mesh material is at the surgeons’ discretion. One disadvantage of this system (in the opinion of Dr. Vardy) is that the anterior introducer is fixed in the maximum depth to which the deep passes can be placed. This was done as a safety measure, preventing an inexperience surgeon from placing the device too deep. However, in some pelvises, this may result in a deployment of the deepest pass of the mesh which is sub-optimal. There are very few surgeons in the US who have the experience to judge these advantages and disadvantages. Until further data from surgical trial is available worldwide, individual surgical experience remains the only means of differentiating the many devices available to the pelvic surgeon today.