Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2015 May;26(5):649-56.
doi: 10.1007/s00192-014-2566-8. Epub 2014 Nov 25.

A randomized trial of vaginal mesh attachment techniques for minimally invasive sacrocolpopexy

Jasmine Tan-Kim  1 , Charles W Nager, Cara L Grimes, Karl M Luber, Emily S Lukacz, Heidi W Brown, Kimberly L Ferrante, Keisha Y Dyer, Anna C Kirby, Shawn A Menefee
Affiliations
Randomized Controlled Trial

A randomized trial of vaginal mesh attachment techniques for minimally invasive sacrocolpopexy

Jasmine Tan-Kim et al. Int Urogynecol J. 2015 May.

Abstract

Introduction and hypothesis: We investigated the efficiency and efficacy of vaginal mesh attachment using interrupted, non-barbed, delayed absorbable sutures in comparison with a running, barbed, delayed absorbable suture during laparoscopic sacrocolpopexy (LSC) and robotic sacrocolpopexy (RSC).

Methods: Women undergoing LSC or RSC were recruited. Participants were randomized to at least six 0 PDS non-barbed interrupted sutures or at least six passes of a 1 PDS barbed suture (Quill™) on each anterior and posterior polypropylene mesh leaflet. The primary outcome was the time to attach the mesh to the vagina. The LSC and RSC groups were block randomized by suture type. Secondary outcomes included: (1) intraoperative surgeon assessment of satisfaction as measured using a 10-cm visual analog scale (VAS), (2) postoperative POP-Q evaluation for anatomic failure, and (3) overall appearance of vaginal walls measured using a VAS.

Results: Of the 64 included subjects who were randomized, 32 had mesh attachment with the barbed suture (16 LSC, 16 RSC) and 32 had attachment with non-barbed sutures (16 LSC, 16 RSC). Among all the subjects (LSC and RSC), the non-barbed suture group had significantly longer mesh attachment times than the barbed suture group (42 vs. 29 min, p < 0.001). The non-barbed suture group had significantly better scores for intraoperative ease of suture placement, surgeon satisfaction with mesh appearance, and global satisfaction. At 12 months, there were no significant differences in anatomic failure between the suture groups or overall appearance of the vaginal walls (p > 0.05).

Conclusions: The barbed suture technique was 11 - 16 min faster for attaching mesh to the vagina than the non-barbed suture technique. Anatomic outcomes at 12 months were comparable between the suture groups. It is reasonable to use a running, barbed suture in minimally invasive sacrocolpopexy.

Trial registration: ClinicalTrials.gov NCT01551992 NCT01608568.

PubMed Disclaimer

References

    1. Arch Dermatol. 2007 Jul;143(7):869-72 - PubMed
    1. J Laparoendosc Adv Surg Tech A. 2013 Sep;23(9):756-9 - PubMed
    1. JAMA. 2014 Mar 12;311(10):1023-34 - PubMed
    1. Surg Innov. 2009 Sep;16(3):237-42 - PubMed
    1. J Minim Invasive Gynecol. 2010 Nov-Dec;17(6):725-9 - PubMed

Publication types

Associated data

LinkOut - more resources