Cargando…

Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model

PURPOSE: There is a novel surgical procedure, called cervicosacropexy (CESA) and vaginosacropexy (VASA) to treat pelvic organ prolapse and a concomitant urgency and mixed urinary incontinence. As there is little experience with the tapes so far and literature is scanty, the aim of this study was to...

Descripción completa

Detalles Bibliográficos
Autores principales: Jansen, Alina Katharina, Ludwig, Sebastian, Malter, Wolfram, Sauerwald, Axel, Hachenberg, Jens, Pahmeyer, Caroline, Wegmann, Kilian, Rudroff, Claudia, Karapanos, Leonidas, Radosa, Julia, Trageser, Nadja, Eichler, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918131/
https://www.ncbi.nlm.nih.gov/pubmed/34842976
http://dx.doi.org/10.1007/s00404-021-06343-w
_version_ 1784668669591158784
author Jansen, Alina Katharina
Ludwig, Sebastian
Malter, Wolfram
Sauerwald, Axel
Hachenberg, Jens
Pahmeyer, Caroline
Wegmann, Kilian
Rudroff, Claudia
Karapanos, Leonidas
Radosa, Julia
Trageser, Nadja
Eichler, Christian
author_facet Jansen, Alina Katharina
Ludwig, Sebastian
Malter, Wolfram
Sauerwald, Axel
Hachenberg, Jens
Pahmeyer, Caroline
Wegmann, Kilian
Rudroff, Claudia
Karapanos, Leonidas
Radosa, Julia
Trageser, Nadja
Eichler, Christian
author_sort Jansen, Alina Katharina
collection PubMed
description PURPOSE: There is a novel surgical procedure, called cervicosacropexy (CESA) and vaginosacropexy (VASA) to treat pelvic organ prolapse and a concomitant urgency and mixed urinary incontinence. As there is little experience with the tapes so far and literature is scanty, the aim of this study was to investigate biomechanical properties for the fixation of the PVDF-tapes with three different fixation methods in context of apical fixations. METHODS: Evaluation was performed on porcine, fresh cadaver sacral spines. A total of 40 trials, divided into 4 subgroups, was performed on the anterior longitudinal ligament. Recorded biomechanical properties were displacement at failure, maximum load and stiffness in terms of the primary endpoints. The failure mode was a secondary endpoint. Group 4 was a reference group to compare single sutures on porcine tissue with those on human tissue. Biomechanical parameters for single sutures on the human anterior longitudinal ligament were evaluated in a previous work by Hachenberg et al. RESULTS: The maximum load for group 1 (two single sutures) was 65 ± 12 N, for group 2 (three titanium tacks arranged in a row) it was 25 ± 10 N and for group 3 (three titanium tacks arranged in a triangle) it was 38 ± 12 N. There was a significant difference between all three groups. The most common failure mode was a “mesh failure” in 9/10 trials for groups 1–3. CONCLUSION: The PVDF-tape fixation with two single sutures endures 2.6 times more load than titanium tacks arranged in a row and 1.7 times more load than titanium tacks arranged in a triangle. The presacral fixation with titanium tacks reduced surgical time compared to the fixation with sutures, nevertheless sutures represent the significantly stronger and cheaper fixation method.
format Online
Article
Text
id pubmed-8918131
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-89181312022-03-17 Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model Jansen, Alina Katharina Ludwig, Sebastian Malter, Wolfram Sauerwald, Axel Hachenberg, Jens Pahmeyer, Caroline Wegmann, Kilian Rudroff, Claudia Karapanos, Leonidas Radosa, Julia Trageser, Nadja Eichler, Christian Arch Gynecol Obstet General Gynecology PURPOSE: There is a novel surgical procedure, called cervicosacropexy (CESA) and vaginosacropexy (VASA) to treat pelvic organ prolapse and a concomitant urgency and mixed urinary incontinence. As there is little experience with the tapes so far and literature is scanty, the aim of this study was to investigate biomechanical properties for the fixation of the PVDF-tapes with three different fixation methods in context of apical fixations. METHODS: Evaluation was performed on porcine, fresh cadaver sacral spines. A total of 40 trials, divided into 4 subgroups, was performed on the anterior longitudinal ligament. Recorded biomechanical properties were displacement at failure, maximum load and stiffness in terms of the primary endpoints. The failure mode was a secondary endpoint. Group 4 was a reference group to compare single sutures on porcine tissue with those on human tissue. Biomechanical parameters for single sutures on the human anterior longitudinal ligament were evaluated in a previous work by Hachenberg et al. RESULTS: The maximum load for group 1 (two single sutures) was 65 ± 12 N, for group 2 (three titanium tacks arranged in a row) it was 25 ± 10 N and for group 3 (three titanium tacks arranged in a triangle) it was 38 ± 12 N. There was a significant difference between all three groups. The most common failure mode was a “mesh failure” in 9/10 trials for groups 1–3. CONCLUSION: The PVDF-tape fixation with two single sutures endures 2.6 times more load than titanium tacks arranged in a row and 1.7 times more load than titanium tacks arranged in a triangle. The presacral fixation with titanium tacks reduced surgical time compared to the fixation with sutures, nevertheless sutures represent the significantly stronger and cheaper fixation method. Springer Berlin Heidelberg 2021-11-29 2022 /pmc/articles/PMC8918131/ /pubmed/34842976 http://dx.doi.org/10.1007/s00404-021-06343-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle General Gynecology
Jansen, Alina Katharina
Ludwig, Sebastian
Malter, Wolfram
Sauerwald, Axel
Hachenberg, Jens
Pahmeyer, Caroline
Wegmann, Kilian
Rudroff, Claudia
Karapanos, Leonidas
Radosa, Julia
Trageser, Nadja
Eichler, Christian
Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
title Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
title_full Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
title_fullStr Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
title_full_unstemmed Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
title_short Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
title_sort tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
topic General Gynecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918131/
https://www.ncbi.nlm.nih.gov/pubmed/34842976
http://dx.doi.org/10.1007/s00404-021-06343-w
work_keys_str_mv AT jansenalinakatharina tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT ludwigsebastian tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT malterwolfram tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT sauerwaldaxel tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT hachenbergjens tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT pahmeyercaroline tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT wegmannkilian tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT rudroffclaudia tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT karapanosleonidas tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT radosajulia tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT tragesernadja tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel
AT eichlerchristian tacksvssuturesabiomechanicalanalysisofsacralbonyfixationmethodsforlaparoscopicapicalfixationsintheporcinemodel