Marta Girvent Vilarmau1,2,3, Felipe Ojeda Pérez4,5, Maria José Canto Rivera5, Marian Lorente Gascón5. 1. Hospital General de Granollers, Barcelona, Spain. mgirvent@uic.es. 2. Universitat Internacional de Catalunya (UIC), Barcelona, Spain. mgirvent@uic.es. 3. , C/ Brutau 30, 5e-1a Sabadell, 08203, Barcelona, Spain. mgirvent@uic.es. 4. Hospital General de Granollers, Barcelona, Spain. 5. Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
Abstract
INTRODUCTION AND HYPOTHESIS: The aim of the study is to facilitate the suture on the sacral promontory for laparoscopic sacrocolpopexy. We hypothesised that a new method of sacral anchorage using a biosynthetic material, the polyether ether ketone (PEEK) harpoon, might be adequate because of its tensile strength, might reduce complications owing to its well-known biocompatibility, and might shorten the duration of surgery. METHODS: We verified the feasibility of insertion and quantified the stress resistance of the harpoons placed in the promontory in nine fresh cadavers, using four stress tests in each case. Mean values were analysed and compared using the Wilcoxon and Fisher's exact tests. RESULTS: The harpoon resists for at least 30 s against a pulling force of 1 N, 5 N and 10 N. Maximum tensile strength is 21 N for the harpoon and 32 N for the suture. Harpoons broke in 6 % and threads in 22 % of cases. Harpoons detached owing to ligament rupture in 64 % of the cases. Regarding failures of the whole complex, the failure involves the harpoon in 92 % of cases and the thread in 56 %. The four possible placements of the harpoon in the promontory were equally safe in terms of resistance to traction. CONCLUSIONS: The PEEK harpoon can be easily anchored in the promontory. Thread is more resistant to traction than the harpoon, but the latter makes the surgical technique easier. Any of the four locations tested is feasible for anchoring the device.
INTRODUCTION AND HYPOTHESIS: The aim of the study is to facilitate the suture on the sacral promontory for laparoscopic sacrocolpopexy. We hypothesised that a new method of sacral anchorage using a biosynthetic material, the polyether ether ketone (PEEK) harpoon, might be adequate because of its tensile strength, might reduce complications owing to its well-known biocompatibility, and might shorten the duration of surgery. METHODS: We verified the feasibility of insertion and quantified the stress resistance of the harpoons placed in the promontory in nine fresh cadavers, using four stress tests in each case. Mean values were analysed and compared using the Wilcoxon and Fisher's exact tests. RESULTS: The harpoon resists for at least 30 s against a pulling force of 1 N, 5 N and 10 N. Maximum tensile strength is 21 N for the harpoon and 32 N for the suture. Harpoons broke in 6 % and threads in 22 % of cases. Harpoons detached owing to ligament rupture in 64 % of the cases. Regarding failures of the whole complex, the failure involves the harpoon in 92 % of cases and the thread in 56 %. The four possible placements of the harpoon in the promontory were equally safe in terms of resistance to traction. CONCLUSIONS: The PEEK harpoon can be easily anchored in the promontory. Thread is more resistant to traction than the harpoon, but the latter makes the surgical technique easier. Any of the four locations tested is feasible for anchoring the device.
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