[Tissue resistance: what about tension-free?].

Area of Science:

• Biomedical Engineering
• Surgical Innovation
• Pelvic Floor Reconstruction

Context:

• Pelvic floor disorders affect millions, necessitating effective surgical interventions.
• Current prostheses (meshes) for pelvic floor repair require robust tissue integration for success.
• Objective quantification of tissue resistance is vital for improving surgical outcomes.

Purpose:

• To quantify the objective tissue resistances of different prostheses used in pelvic floor surgery.
• To evaluate the impact of mesh width and surgical route on tissue resistance.
• To provide data for optimizing mesh design and surgical techniques.

Summary:

• Tissue resistance was measured in Newtons on cadavers using a dynamometer for five mesh types and four surgical routes.
• Wider Prolene meshes demonstrated improved tissue resistance and fixation.
• The trans-sacrospinous route offered superior resistance compared to the trans-muscular route.

Impact:

• Findings suggest wider posterior mesh arms (>1 cm) placed via the trans-sacrospinous ligament improve fixation.
• Mesh knitting and mechanical properties are critical for immediate postoperative resistance.
• This research can guide manufacturers in developing specialized meshes for tension-free pelvic floor repair.