Universität zu Köln

Sauerwald, A., Niggl, M., Puppe, J., Prescher, A., Scaal, M., Noe, G. K., Schiermeier, S., Warm, M. and Eichler, C. (2016). Laparoscopic Pectopexy: A Biomechanical Analysis. PLoS One, 11 (2). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Introduction Pectopexy, a laparoscopic method for prolapse surgery, showed promising results in recent literature. Further improving this approach by reducing surgical time may decrease complication rates and patient morbidity. Since laparoscopic suturing is a time consuming task, we propose a single suture /mesh ileo-pectineal ligament fixation as opposed to the commonly used continues approach. Methods Evaluation was performed on human non-embalmed, fresh cadaver pelves. A total of 33 trials was performed. Eight female pelves with an average age of 75, were used. This resulted in 16 available ligaments. Recorded parameters were ultimate load, displacement at failure and stiffness. Results The ultimate load for the mesh + simplified single interrupted suture (MIS) group was 35 (+/- 12) N and 48 (+/- 7) N for the mesh + continuous suture (MCS) group. There was no significant difference in the ultimate load between both groups (p>0.05). This was also true for displacement at failure measured at 37 (+/- 12) mm and 36 (+/-5) mm respectively. There was also no significant difference in stiffness and failure modes. Conclusion Given the data above we must conclude that a continuous suture is not necessary in laparoscopic mesh /ileo-pectineal ligament fixation during pectopexy. Ultimate load and displacement at failure results clearly indicate that a single suture is not inferior to a continuous approach. The use of two single sutures may improve ligamental fixation. However, overall stability should not benefit since the surgical mesh remains the limiting factor.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sauerwald, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Niggl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Puppe, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prescher, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scaal, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Noe, G. K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiermeier, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Warm, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichler, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-284753
DOI:	10.1371/journal.pone.0144143
Journal or Publication Title:	PLoS One
Volume:	11
Number:	2
Date:	2016
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FIXED-ANGLE PLATE; TRANSVERSE PATELLA FRACTURES; IN-VIVO; SACROCOLPOPEXY; FIXATION; PROLAPSE; MESH; LIGAMENT; CADAVER Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28475