The CapioTM device is then used to place the suspension sutures. 3 sutures are placed: 2 delayed-absorbable (0 PDS) and 1 permanent (0 prolene). All sutures are placed one and a half to two fingerbreadths (2-3cm) medial to the ischial spine in a sequential fashion. After placement, a rectal exam is done to ensure that no sutures have been placed through the rectum and the coccygeus-sacrospinous ligament complex is visualized carefully to ensure that the surgical site is hemostatic. The absorbable-delayed suspension sutures are placed through the vaginal epithelium at the level of the neoapex and all permanent sutures are placed through the subepithelial tissue.