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Evaluation of surgical instrument handling on polypropylene mesh using scanning electron microscopy

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Abstract

Introduction and hypothesis

To evaluate the effect of surgical instruments handling on polypropylene mesh using scanning electron microscopy (SEM).

Methods

We applied different surgical instruments, including a few robotic ones, to pieces of polypropylene mesh. SEM was used to evaluate the morphological changes with this intervention.

Results

Straight hemostat, laparoscopic atraumatic grasper, laparoscopic needle driver, and robotic instruments (Bipolar forceps, Cadiere™ forceps, PK™ dissecting forceps and SutureCut™) were applied to the mesh. SEM images of tool-affected mesh regions in specimens handled by different instruments along with the images of intact mesh were obtained. Average mesh fiber diameters, as well as the average parameters characterizing instrument-affected regions, were measured. There was substantial widening of the fibers in specimens handled by hemostat or a needle holder. An elliptical but much longer and narrower tool marking with more surface roughness was observed in mesh handled by a grasper. A ∼25-μm-wide and ∼200-μm-long strap was split on one side from the core of the fiber caused by Cadiere™.

Conclusions

There are morphological changes to polypropylene mesh caused by instrument handling. These changes are different depending on the instrument used. These alterations vary from changes in the surface creating roughness of the fiber, compression of the mesh with narrowing of the fiber in at least one direction or actual splitting or pitting of the fiber. Since there are no data regarding the effect of these morphological changes to the ultimate functioning of the mesh, surgeons should minimize mesh handling by instruments.

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Acknowledgements

The authors acknowledge Adair R. Heyl, PhD, for assistance in writing the manuscript.

Financial disclaimer/conflicts of interest

SL Francis: Astellas speaker, Pfizer speaker, and Intuitive Proctor; R Pasic: Cooper Surgical speaker, Ethicon speaker, Endo and Storz speaker; DR Ostergard: Astellas speaker and Medicolegal consultations and testimony.

A Azadi, JB Jasinski, L Lipetskaia, NE Deveneau, T Yeganeh: None

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology and Women’s Health, University of Louisville, Louisville, KY, USA

    Ali Azadi, Sean L. Francis, Resad Pasic, Lioudmila Lipetskaia, Nicolette E. Deveneau & Donald R. Ostergard

  2. Conn Center for Renewable Energy Research, University of Louisville, Louisville, KY, USA

    Jacek B. Jasinski

  3. University of Louisville, Louisville, KY, USA

    Taraneh Yeganeh

  4. 550 South Jackson, 2nd Floor Bridge, Louisville, KY, 40202, USA

    Ali Azadi

Authors
  1. Ali Azadi
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  2. Jacek B. Jasinski
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  3. Sean L. Francis
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  4. Resad Pasic
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  5. Lioudmila Lipetskaia
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  6. Nicolette E. Deveneau
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  7. Taraneh Yeganeh
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  8. Donald R. Ostergard
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Corresponding author

Correspondence to Ali Azadi.

Additional information

IRB

No IRB was required for this study since this experiment did not include any human subjects and it was conducted at the School of Engineering.

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Azadi, A., Jasinski, J.B., Francis, S.L. et al. Evaluation of surgical instrument handling on polypropylene mesh using scanning electron microscopy. Int Urogynecol J 25, 651–656 (2014). https://doi.org/10.1007/s00192-013-2271-z

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  • DOI: https://doi.org/10.1007/s00192-013-2271-z

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