Introducing a method of in vitro testing of different anchoring systems used for female incontinence and prolapse surgery.

AIMS: To develop a method for in vitro testing to compare different intracorporeal anchoring systems (AS) used, for example, in single-incision slings or vaginal meshes. Intracorporeal fixation needs reliable anchorage systems, which keep the implant in the operative and early postoperative phase in place. Up to now, the impact of the design of current anchor systems and their capability to provide sufficient retention forces is not known. METHODS: Four AS ("PelFix", "Surelift", "TFS", and "MiniArc") were evaluated in an animal model and a ballistic gelatine model with pull-out tests. We performed ANOVA with post hoc Bonferroni. Results were presented as mean values whereby a significance level of <0.05 was considered significant. RESULTS: The four systems showed significantly different pull-out forces. Depending on mesh structure, size, and form of the AS, mechanical strain resulted in deformation with local peak stresses. Under the condition of form stability, relative differences of pull-out forces did not change in different tissues. CONCLUSIONS: Reliable testing of different AS in their ability to keep mesh implants in place can be done in animal models and in especially designed ballistic gelatine. These methods of testing will help to modify AS in novel pelvic floor implants.

New measurements to compare soft tissue anchoring systems in pelvic floor surgery.

Suburethral slings as well as different meshes are widely used treating stress urinary incontinence and prolaps in women. With the development of MiniSlings and special meshes using less alloplastic material anchorage systems become more important to keep devices in place and to put some tension especially on the MiniSlings. To date, there are many different systems of MiniSlings of different companies on the market which differ in the structure of the used meshes and anchors. A new objective measurement method to compare different properties of MiniSling systems (mesh and anchor) is presented in this article. Ballistic gelatine acts as soft tissue surrogate. Significant differences in parameters like pull-out strength of anchors or shrinkage of meshes under loading conditions have been determined. The form and size of the anchors as well as the structural stability of the meshes are decisive for a proper integration. The tested anchorings sytems showed markedly different mechanical function at their respective load bearing capacity. As the stable fixation of the device in tissue is a prerequisite for a permanet reinforcement, the proposed test system permits further optimisation of anchor and mesh devices to improve the success of the surgical treatment.

Solitary fibrous tumor of the kidney: a case report.

A solitary fibrous tumor of the kidney is a rare neoplasm that was often misdiagnosed as hemangiopericytoma, until recently. We report a case of a 35-year-old male patient with a solid, 7 cm tumor located centrally in a solitary right kidney. The patient underwent successful bench surgery and autotransplantation.

Modification of a functional motor task by non-consciously perceived sensory stimuli.

In recent years it has been suggested that processing of visual information is divided between a ventral stream, responsible for object recognition and conscious processing of object properties, and a dorsal stream mediating automatic integration of visual information into a motor task. We used metacontrast masking to prevent conscious perception of visual cues concerning the load of an object to be lifted in a precision grip. It was found that when such non-consciously perceived cues warned of a load change, they allowed the subjects to produce the grip force profile appropriate to the new load. It is concluded that non-consciously perceived visual information can be utilised to adapt a functional motor task to actual conditions.