Faculty Collaboration Database

The tensile strength of Cooper's ligament suturing: comparison of abdominal and transvaginal techniques. Int Urogynecol J Pelvic Floor Dysfunct 2004;15(6):425-7; discussion 428

Date

07/28/2004

Pubmed ID

15278253

DOI

10.1007/s00192-004-1189-x

Scopus ID

2-s2.0-8544276589 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

This study was designed to compare the strength and position of sutures anchored into Cooper's ligament utilizing a minimally invasive transvaginal suturing technique, versus the 'open' abdominal approach. In 12 fresh cadavers, Cooper's ligament was accessed via abdominal and vaginal incisions. After randomization, polytetrafluoroethylene (00) sutures were spaced along one ligament with the transvaginal device (n=36). Contralaterally, sutures were placed abdominally (n=36). Progressive load was applied until suture breakage or dislodgement, and tensile strength was measured using a digital tensiometer. Peak tension averaged 14.5 psi for abdominal and 12.96 psi for vaginal (p=0.28). Suture breakage rather than ligament 'pullout' was more likely for abdominal (95 vs. 56%, p=0.0001). Vaginal and abdominal sutures demonstrated nearly identical mean distances from mid-symphysis (4.62 vs. 4.24 cm, p=0.56). Peak tension was not correlated with suture location (r2=0.17, p=0.28). We conclude that transvaginal suturing, using the minimally invasive device, achieved similar tensile strength and position to the open technique. Transvaginal sutures were associated with greater likelihood of ligament 'pullout' before suture breakage under maximal load; however, the clinical implications of this finding are uncertain.

Author List

Goldberg RP, Koduri S, Sand PK, Kwon C, Culligan P

MESH terms used to index this publication - Major topics in bold

Abdomen
Cadaver
Female
Humans
Ligaments
Minimally Invasive Surgical Procedures
Surgical Mesh
Suture Techniques
Tensile Strength
Urinary Incontinence
Urologic Surgical Procedures
Vagina