Universität zu Köln

Sebastian, Ludwig, Alina, Jansen, Fabinshy, Thangarajah, Dominik, Ratiu, Axel, Sauerwald, Jens, Hachenberg, Kilian, Wegmann, Claudia, Rudroff, Leonidas, Karapanos, Julia, Radosa, Nadja, Trageser and Christian, Eichler (2023). AbsorbaTack((TM)) vs. ProTack((TM)) vs. sutures: a biomechanical analysis of cervical fixation methods for laparoscopic apical fixations in the porcine model. Arch. Gynecol. Obstet., 307 (3). S. 863 - 872. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-0711

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sebastian, Ludwig UNSPECIFIED UNSPECIFIED UNSPECIFIED Alina, Jansen UNSPECIFIED UNSPECIFIED UNSPECIFIED Fabinshy, Thangarajah UNSPECIFIED UNSPECIFIED UNSPECIFIED Dominik, Ratiu UNSPECIFIED UNSPECIFIED UNSPECIFIED Axel, Sauerwald UNSPECIFIED UNSPECIFIED UNSPECIFIED Jens, Hachenberg UNSPECIFIED UNSPECIFIED UNSPECIFIED Kilian, Wegmann UNSPECIFIED UNSPECIFIED UNSPECIFIED Claudia, Rudroff UNSPECIFIED UNSPECIFIED UNSPECIFIED Leonidas, Karapanos UNSPECIFIED UNSPECIFIED UNSPECIFIED Julia, Radosa UNSPECIFIED UNSPECIFIED UNSPECIFIED Nadja, Trageser UNSPECIFIED UNSPECIFIED UNSPECIFIED Christian, Eichler UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-683405
DOI:	10.1007/s00404-022-06827-3
Journal or Publication Title:	Arch. Gynecol. Obstet.
Volume:	307
Number:	3
Page Range:	S. 863 - 872
Date:	2023
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-0711
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MESH FIXATION; URINARY-INCONTINENCE; PROLAPSE; OUTCOMES; SURGERY; PVDF Multiple languages Obstetrics & Gynecology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68340