The tensile strength of uterosacral ligament sutures: A comparison of vaginal and laparoscopic techniques
| Autor: | Michael Heit, Miles Murphy, Carol A. Graham, Meg Hainer, Patrick J. Culligan, Robert D. Moore, Roger P. Goldberg, John R. Miklos |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Sacrum
medicine.medical_specialty Uterosacral ligament Ischial spine Ureter Suture (anatomy) Cadaver Tensile Strength medicine Humans Aged Ligaments medicine.diagnostic_test business.industry Suture Techniques Uterus Obstetrics and Gynecology Anatomy Plastic Surgery Procedures Surgery Endoscopy medicine.anatomical_structure Vagina Ligament Female Laparoscopy business |
| Zdroj: | Obstetrics & Gynecology. 101:500-503 |
| ISSN: | 0029-7844 |
| DOI: | 10.1016/s0029-7844(02)03123-x |
| Popis: | model. METHODS: In 12 unembalmed cadavers, four polytetra.fluoroethylene sutures were placed through the uterosacral ligaments. In each cadaver, two sutures were placed laparoscopically, and two more were placed vaginally. A single, experienced surgeon placed alliaparoscopic sutures (n = 23), and another experienced surgeon placed all vaginal sutures (n = 22). A blinded team of investigators measured the distance from each suture to the ipsilateral ischial spine; determined whether any sutures incorporated ureters, viscera, or large vessels; and then passed the sutures through an apical vaginal incision. Using a hand-held tensiometer, progressive tensile load was then applied to these sutures along the axis of the vagina until they either broke or were completely dislodged from the ligaments. RESULTS: The average peak tension required to break or dislodge the sutures was 26.2 :t 8.8 psi (Iaparoscopic) and 22.5 :t 7.4 psi (vaginal) (P = .14,95% confidence interval [CI] -1.2, 8.6). The average force required for suture breakage (n = 28) was 28 :t 7 psi, and the average force applied when ligament failure occurred (n = 17) was 18.5 :t 6 psi (P < .001, 95% CI -13.8, -5.2). The average distance from a laparoscopic or vaginal suture to the ipsilateral ischial spine was 19.1 :t 7 mm and 17.4 :t 6 mm, respectively (P = .46,95% CI -3.0, 6.4). None of the sutures from either technique were found to incorporate a visceral structure, ureter, or great vessel. CONCLUSION: These suturing techniques appear to be equal in tensile strength. (Obstet Gynecol 2003;101:500-3. @ 2003 by The American College of Obstetricians and Gynecologists.) |
| Databáze: | OpenAIRE |
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