Laparoscopic Pectopexy: A Biomechanical Analysis

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 /mes...

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Published in:PloS one 2016-02, Vol.11 (2), p.e0144143-e0144143
Main Authors: Sauerwald, A, Niggl, M, Puppe, J, Prescher, A, Scaal, M, Noé, G K, Schiermeier, S, Warm, M, Eichler, C
Format: Article
Language:English
Subjects:
Abdomen
Aged
Analysis
Bariatric surgery
Biology and Life Sciences
Biomechanical engineering
Biomechanical Phenomena
Biomechanics
Breast cancer
Cadaver
Clinical trials
Displacement
Failure modes
Female
Fixation
Fractures
Gynecology
Human performance
Humans
Laparoscopy
Laparoscopy - methods
Ligaments
Ligaments - surgery
Load
Medicine and Health Sciences
Methods
Morbidity
Obesity
Obstetrics
Pelvic Organ Prolapse - surgery
Pelvis - surgery
Physical Sciences
Research and Analysis Methods
Stiffness
Surgery
Surgical Mesh
Suture Techniques
Sutures
Ultimate loads
Weight-Bearing
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cited_by cdi_FETCH-LOGICAL-c692t-beff0d88221b5c93cc0d5912ba94f90f8e94438f0e4877bfa4add0da1e5f2b7e3
cites cdi_FETCH-LOGICAL-c692t-beff0d88221b5c93cc0d5912ba94f90f8e94438f0e4877bfa4add0da1e5f2b7e3
container_end_page e0144143
container_issue 2
container_start_page e0144143
container_title PloS one
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creator Sauerwald, A
Niggl, M
Puppe, J
Prescher, A
Scaal, M
Noé, G K
Schiermeier, S
Warm, M
Eichler, C
description 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. 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. 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. 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.
doi_str_mv 10.1371/journal.pone.0144143
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subjects Abdomen
Aged
Analysis
Bariatric surgery
Biology and Life Sciences
Biomechanical engineering
Biomechanical Phenomena
Biomechanics
Breast cancer
Cadaver
Clinical trials
Displacement
Failure modes
Female
Fixation
Fractures
Gynecology
Human performance
Humans
Laparoscopy
Laparoscopy - methods
Ligaments
Ligaments - surgery
Load
Medicine and Health Sciences
Methods
Morbidity
Obesity
Obstetrics
Pelvic Organ Prolapse - surgery
Pelvis - surgery
Physical Sciences
Research and Analysis Methods
Stiffness
Surgery
Surgical Mesh
Suture Techniques
Sutures
Ultimate loads
Weight-Bearing
title Laparoscopic Pectopexy: A Biomechanical Analysis
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