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Published in Charles E. Carraher, Carraher's Polymer Chemistry, 2017
Polytetrafluoroethylene (PTFE), is often impregnated into sutures and used as a coating, promoting the reduction of tissue drag and biological inertness. Gore-Tex sutures are a monofilament PTFE and part of a grouping of PTFE biological implants called ePTFE. Gore-Tex is 50% air by volume. It has good tensile strength, inertness, slipperiness, ties like silk, and offers good knot security. Suture-related bleeding is reduced because they can be swaged to needles that closely approximate the thread diameter. It is especially used for vaginal reconstructive surgery for perivesical and sacrospinous ligament support.
The transvaginal mesh: an overview of indications and contraindications for its use
Published in Expert Review of Medical Devices, 2023
Alessandro Ferdinando Ruffolo, Marine Lallemant, Sophie Delplanque, Michel Cosson
MUS for SUI management and TVM for POP treatment are the main meshes transvaginally implanted in urogynecology. In the past, several materials have been used for transvaginal mesh implantation. Nowadays, the polypropylene is the most adopted material for transvaginal devices, mainly the type 1 macroporous monofilament polypropylene, a synthetic, non-absorbable material with large pores and variously shaped (sling, rectangle, or more complex shapes) according to the scheduled surgical procedure [3]. However, the quality of the material may differ depending on the manufacturers. The TVM technique involves the placement of the mesh in the vescico-vaginal or recto-vaginal space, depending on the vaginal compartment involved in POP, usually anchored at the sacrospinous ligament (SSL) or at the arcus tendinous of pelvic fascia (ATPF). Second-generation TVMs are smaller than previous devices and are usually attached to the SSL through an anterior approach [4].
A computational study of organ relocation after laparoscopic pectopexy to repair posthysterectomy vaginal vault prolapse
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2020
Obesity is associated with an increased risk of genital prolapse (Irvine and Shawn 2003), the fatty tissue enlarged sigmoid colon provides less room for sacrocolpopexy technique, which is considered to be the gold standard for correcting the vaginal vault or apical prolapse and reconstituting the physiological vaginal axis (Beer and Kuhn 2005; Bhattarai et al. 2018). In obese patients, the mesh implanted between the sacrum and the vagina/cervical stump narrows the pelvis, which might result in defaecation disorders, adhesions or trauma of the hypogastric nerves (Akladios et al. 2010). First introduced in 2007 (Banerjee and Noé 2011), laparoscopic pectopexy minimises such risks and has rapidly emerged as a promising technique for the prolapse repair in obese patients with good postoperative outcomes. This method uses the lateral parts of the iliopectineal ligament (Cooper ligament) for a bilateral mesh fixation (Noé et al. 2015). The mesh implant carefully follows the direction of the round and broad ligaments without crossing or interfering sensitive areas such as the ureter, bowel or hypogastric trunk which offers zero restriction to the organ function by the implant. In this way, fixation to the stable and significantly stiffer iliopectineal ligament compared to the sacrospinous ligament and arcus tendinous fasciae pelvis ensures a more physiological axis of the vagina (Cosson et al. 2003; Noé et al. 2015).
Development of a flexible instrumented lumbar spine finite element model and comparison with in-vitro experiments
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Aleksander Leszczynski, Frank Meyer, Yann-Philippe Charles, Caroline Deck, Rémy Willinger
The five major ligaments around the pelvis were also modeled: Anterior Sacroiliac Ligament (ASL), Posterior Sacroiliac Ligament (PSL), Interosseous Ligament (IOL), Sacrospinous Ligament (SS) and Sacrotuberous Ligament (ST). Pelvic ligaments were meshed as spring elements (Figure 3b).