Abstract

Purpose

Treatment of pelvic organ prolapse (POP) often requires the use of synthetic mesh. In case of a novel and standardized bilateral apical fixation, both uterosacral ligaments are replaced by polyvinylidene-fluoride (PVDF) tapes. One of the main problems remains the fixation method, which should be stable, but also simple and quick to use. The current study evaluated biomechanical differences between the cervical tape fixation with sutures (group 1), non-absorbable tacks (group 2) and absorbable tacks (group 3) in an in vitro porcine model.

Methods

A total of 28 trials, conducted in three groups, were performed on porcine, fresh cadaver uteri. All trials were performed until mesh, tissue or fixation device failure occurred. Primary endpoints were the biomechanical properties maximum load (N), displacement at failure (mm) and stiffness (N/mm). The failure mode was a secondary endpoint.

Results

There was a significant difference between all three groups concerning the maximum load. Group 1 (sutures) supported a maximum load of 64 ± 15 N, group 2 (non-absorbable tacks) yielded 41 ± 10 N and group 3 (absorbable tacks) achieved 15 ± 8 N.

The most common failure mode was a mesh failure for group 1 and 2 and a fixation device failure for group 3.

Conclusion

The PVDF-tape fixation with sutures supports 1.5 times the load that is supported by non-absorbable tacks and 4.2 times the load that is supported by absorbable tacks. Nevertheless, there was also a stable fixation through tacks. Sutures are the significantly stronger and cheaper fixation device but may prolong the surgical time in contrast to the use of tacks.

Details

Title
AbsorbaTack™ vs. ProTack™ vs. sutures: a biomechanical analysis of cervical fixation methods for laparoscopic apical fixations in the porcine model
Author
Sebastian, Ludwig 1   VIAFID ORCID Logo  ; Alina, Jansen 1 ; Fabinshy, Thangarajah 1 ; Dominik, Ratiu 1 ; Axel, Sauerwald 2 ; Jens, Hachenberg 3 ; Kilian, Wegmann 4 ; Claudia, Rudroff 5 ; Leonidas, Karapanos 6 ; Julia, Radosa 7 ; Nadja, Trageser 1 ; Christian, Eichler 8 

1  University of Cologne, Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777) 
2  St. Marien Hospital Düren, Department of Gynecology and Obstetrics, Düren, Germany (GRID:grid.440275.0) 
3  Hannover Medical School, Department of Gynecology and Obstetrics, Hannover, Germany (GRID:grid.10423.34) (ISNI:0000 0000 9529 9877) 
4  University of Cologne, Department for Trauma, Hand and Elbow Surgery, Faculty of Medicine and University Hospital Cologne, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777) 
5  Evangelisches Krankenhaus Köln-Weyertal, Department of General Surgery, Cologne, Germany (GRID:grid.6190.e) 
6  University of Cologne, Department of Urology, Uro-Oncology, Faculty of Medicine and University Hospital Cologne, Robot- Assisted and Reconstructive Surgery, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777) 
7  Saarland University Hospital, Department for Gynecology, Obstetrics and Reproductive Medicine, Homburg, Germany (GRID:grid.411937.9) 
8  University of Cologne, Department of Gynecology and Obstetrics, Faculty of Medicine and University Hospital Cologne, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777); St. Franziskus-Hospital Münster, Breast Cancer Center, Münster, Germany (GRID:grid.416655.5) 
Pages
863-871
Publication year
2023
Publication date
Mar 2023
Publisher
Springer Nature B.V.
ISSN
09320067
e-ISSN
14320711
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1007/s00404-022-06827-3
ProQuest document ID
2781922456
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.