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1000 Titel
  • Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model
1000 Autor/in
  1. Jansen, Alina Katharina |
  2. Ludwig, Sebastian |
  3. Malter, Wolfram |
  4. Sauerwald, Axel |
  5. Hachenberg, Jens |
  6. Pahmeyer, Caroline |
  7. Wegmann, Kilian |
  8. Rudroff, Claudia |
  9. Karapanos, Leonidas |
  10. Radosa, Julia |
  11. Trageser, Nadja |
  12. Eichler, Christian |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-11-29
1000 Erschienen in
1000 Quellenangabe
  • 305(3):631-639
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00404-021-06343-w |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918131/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
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1000 Abstract/Summary
  • 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.
1000 Sacherschließung
lokal Sacrum/surgery [MeSH]
lokal Laparoscopy/methods [MeSH]
lokal Swine [MeSH]
lokal Pelvic Organ Prolapse/complications [MeSH]
lokal Urogynaecological surgery
lokal Cervicosacropexy
lokal Humans [MeSH]
lokal Sutures [MeSH]
lokal Biomechanical Phenomena [MeSH]
lokal General Gynecology
lokal Animals [MeSH]
lokal Pelvic Organ Prolapse/surgery [MeSH]
lokal Uterosacral ligaments
lokal Polyvinylidene-fluoride
lokal Vaginosacropexy
lokal Suture Techniques [MeSH]
lokal Pelvic organ prolapse
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  1. https://frl.publisso.de/adhoc/uri/SmFuc2VuLCBBbGluYSBLYXRoYXJpbmE=|https://frl.publisso.de/adhoc/uri/THVkd2lnLCBTZWJhc3RpYW4=|https://frl.publisso.de/adhoc/uri/TWFsdGVyLCBXb2xmcmFt|https://frl.publisso.de/adhoc/uri/U2F1ZXJ3YWxkLCBBeGVs|https://frl.publisso.de/adhoc/uri/SGFjaGVuYmVyZywgSmVucw==|https://frl.publisso.de/adhoc/uri/UGFobWV5ZXIsIENhcm9saW5l|https://frl.publisso.de/adhoc/uri/V2VnbWFubiwgS2lsaWFu|https://frl.publisso.de/adhoc/uri/UnVkcm9mZiwgQ2xhdWRpYQ==|https://frl.publisso.de/adhoc/uri/S2FyYXBhbm9zLCBMZW9uaWRhcw==|https://frl.publisso.de/adhoc/uri/UmFkb3NhLCBKdWxpYQ==|https://frl.publisso.de/adhoc/uri/VHJhZ2VzZXIsIE5hZGph|https://frl.publisso.de/adhoc/uri/RWljaGxlciwgQ2hyaXN0aWFu
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