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Peter Petros - One of the best experts on this subject based on the ideXlab platform.
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Perineal body repair in patients with third degree rectocele: a critical analysis of the Tissue Fixation system.
Colorectal Disease, 2013Co-Authors: Florian M E Wagenlehner, G A Santoro, Peter PetrosAbstract:Aim We describe the technique of Tissue Fixation system (TFS) perineal body repair in patients presenting with symptomatic third degree rectocele. Method The single sling TFS perineal body repair is performed in three surgical steps: (i) dissection of the rectum off the vagina and laterally displaced perineal body; (ii) identification of the deep transverse perineii muscles beyond their insertion point behind the descending pubic ramus; (iii) elevation and approximation of the separated and laterally displaced perineal bodies by insertion, without tension, of non-stretch 7 mm polypropylene tape into the bodies of the deep transverse perineii muscles. Results From January 2007 to December 2009 we performed the TFS operation for 30 women, median age 61 (range 47–87) years, mean parity 2.6 (range 1–5), with third degree symptomatic low rectocele (median obstructive defaecation syndrome score 19; range 11–24). Median hospital stay was 24 (range 12–96) h. The median visual analogue scale for postoperative pain was 1 (range 1–7). Complications occurred in three cases (10%) and included a surfaced tape that was partly resected (repair maintained), a recurrence of the rectocele due to incorrect placement (failed repair) and a foreign body abscess requiring tape removal. At 12-month follow-up, 27 patients (90%) reported normal defaecation and the median obstructive defaecation syndrome score was significantly reduced to 4 (range 1–6; P
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Midurethral Tissue Fixation system (TFS) sling for cure of stress incontinence--3 year results.
International urogynecology journal and pelvic floor dysfunction, 2008Co-Authors: Peter Petros, Peter RichardsonAbstract:We have previously reported preliminary (9 month) results using the Tissue Fixation system (TFS) in patients with stress incontinence. The aim of the study was to assess the effectiveness of the TFS in patients with genuine stress incontinence at 3 years. The TFS uses two small plastic anchors to fix a (adjustable) midurethral polypropylene mesh sling into the pelvic muscles and Tissues below the retropubic space. Thirty-six patients with stress incontinence, mean age 55 (35–87), mean weight 76 kg, (33–117 kg), mean 0.8 previous operations for stress incontinence, underwent a TFS midurethral sling operation between 2003 and 2004. The suburethral vaginal fascia was also tightened. The patients were contacted by telephone independently by a nurse. The critical question was “Do you leak when you cough?” A negative answer was taken as a cure. If she said “sometimes”, she was asked on a scale of 1 to 100 what her improvement was. Of the 31 patients contacted, total symptomatic cure was reported by 25 patients (80%) and >70% cure in a further two patients (6.5%). Five patients could not be contacted. There was a slight deterioration in cure rate for stress incontinence between 9 months and 3 years, similar to that seen with retropubic midurethral sling surgery.
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Study No. 11: Ligamentous repair using the Tissue Fixation System confirms a causal link between damaged suspensory ligaments and urinary and fecal incontinence
2008Co-Authors: Burghard Abendstein, Peter Petros, Peter RichardsonAbstract:AIM. The aims of this study were: 1. To test the efficacy of a less invasive method (TFS) for tape implantation in patients with vaginal prolapse, urinary and fecal incontinence; 2. To test the contribution of ATFP/cardinal and their attached fascia (cystocoele repair), if any, to causation of fecal incontinence. PATIENTS AND METHODS. Eighty-one patients, mean age 60.1, mean weight 69 kg (43-112 kg), mean 2.0 previous pelvic operations, underwent 154 site specific operations in the 3 zones of the vagina as primary procedures using the Tissue Fixation System (TFS). The site of operation(s) was determined by reference to a pictorial diagnostic algorithm: pubourethral ligaments, n=43; ATFP, cardinal ligaments, (cystocoele) n = 39; uterosacral ligaments (apical prolapse), n = 72. The patients were assessed with a 24 hour urinary diary, structured questionnaire, transperineal ultrasound, urodynamics, cough stress test, and 24 hour pad test, pre and post-operatively at mean 12 months (6-18 months). RESULTS. Symptom improvement was as follows: fecal incontinence (n = 33) 88%, stress incontinence (n = 43) 89%, urgency and nocturia (n = 50) 80%. CONCLUSIONS. Both urinary and fecal incontinence (FI) symptoms were simultaneously cured, indicating a causal link. Repair of ATFP and cardinal ligament defects (cystocoele) did not produce a significantly higher cure rate for FI to that achieved by repairing just the anterior and/or posterior suspensory ligaments in studies No 9 & 10, indicating perhaps, the primacy of anterior and/or posterior suspensory ligaments in FI control.
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The Tissue Fixation System provides a new structural method for cystocoele repair: a preliminary report.
The Australian & New Zealand journal of obstetrics & gynaecology, 2006Co-Authors: Peter Petros, Peter Richardson, Klaus Goeschen, Burghard AbendsteinAbstract:Background: A new reconstruction principle that uses tensioned tapes instead of large mesh is described for cystocoele repair. Aim: To apply this method to patients with central, paravaginal and cervical ring defects. Methods: Ninety patients, mean age 63 years (29–83) and mean weight 73 kg (52–117 kg), underwent cystocoele repair using the Tissue Fixation System (TFS). Tapes were applied as a retro-obturator U-sling (n = 29), transversely between both arcus tendineus fascia pelvis (ATFP) ligaments (n = 45), along the path of the cardinal ligament in patients with cervical ring defects (n = 12), and longitudinally along the ATFP ligament (n = 4). Results: At mean eight months review (three to 15 months), two failures were reported. There was one haematoma that drained spontaneously at seven days, and there were no erosions. Mean hospital stay was one a half days for the Australian group (one to seven days) and five days (four to eight days) for the European group. After using single U-sling, one patient required intermittent catheterisation for seven days before she could pass urine freely. In one patient the bladder was perforated during dissection laterally towards the ATFP; the perforation was successfully repaired. Conclusions: The tensioned tape operation is simple and accurate, and appears to work well in the short term. Longer-term studies are required.
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midurethral Tissue Fixation system sling a micromethod for cure of stress incontinence preliminary report
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2005Co-Authors: Peter Petros, Peter RichardsonAbstract:Aims: To assess the effectiveness of the Tissue Fixation System (TFS) in patients with stress incontinence. The TFS uses two small plastic anchors to fix an (adjustable) midurethral polypropylene mesh sling into the soft Tissues below the pubic bone. Patients and methods: Thirty-six patients with stress incontinence, mean age 55 (35–87), mean weight 76 kg (33–117 kg), mean 0.8 previous operations for stress incontinence, underwent a TFS midurethral sling operation. The patients were preoperatively assessed with a structured questionnaire, 24-h urinary diary, cough stress test, transperineal ultrasound, and urodynamics. Using the TFS delivery system, a midurethral mesh tape was attached to the fibromuscular Tissues behind the perineal membrane. The suburethral vaginal fascia was also tightened. Post-operatively. the patients were reviewed at 6 weeks, and at 3-monthly intervals with ultrasound, and cough stress tests. Results: Primary symptomatic cure rate at mean 9 months (3–15 months) was 83.4% (n = 36). Pad test loss decreased from a mean 12.7 g to a mean of 0.2 g; mean operating time was 5 min, and mean hospital stay was 24 h (12–48 h). There were no cases of obstructed micturition, and minimal analgesia only was required postoperatively. Conclusion: The TFS is a promising new method. The results at this stage are similar to those achieved previously with the ‘tension-free’ tape operations, but with greater safety and shorter operating time. Testing by other surgeons will be required to evaluate this method further.
Peter Richardson - One of the best experts on this subject based on the ideXlab platform.
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Midurethral Tissue Fixation system (TFS) sling for cure of stress incontinence--3 year results.
International urogynecology journal and pelvic floor dysfunction, 2008Co-Authors: Peter Petros, Peter RichardsonAbstract:We have previously reported preliminary (9 month) results using the Tissue Fixation system (TFS) in patients with stress incontinence. The aim of the study was to assess the effectiveness of the TFS in patients with genuine stress incontinence at 3 years. The TFS uses two small plastic anchors to fix a (adjustable) midurethral polypropylene mesh sling into the pelvic muscles and Tissues below the retropubic space. Thirty-six patients with stress incontinence, mean age 55 (35–87), mean weight 76 kg, (33–117 kg), mean 0.8 previous operations for stress incontinence, underwent a TFS midurethral sling operation between 2003 and 2004. The suburethral vaginal fascia was also tightened. The patients were contacted by telephone independently by a nurse. The critical question was “Do you leak when you cough?” A negative answer was taken as a cure. If she said “sometimes”, she was asked on a scale of 1 to 100 what her improvement was. Of the 31 patients contacted, total symptomatic cure was reported by 25 patients (80%) and >70% cure in a further two patients (6.5%). Five patients could not be contacted. There was a slight deterioration in cure rate for stress incontinence between 9 months and 3 years, similar to that seen with retropubic midurethral sling surgery.
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Study No. 11: Ligamentous repair using the Tissue Fixation System confirms a causal link between damaged suspensory ligaments and urinary and fecal incontinence
2008Co-Authors: Burghard Abendstein, Peter Petros, Peter RichardsonAbstract:AIM. The aims of this study were: 1. To test the efficacy of a less invasive method (TFS) for tape implantation in patients with vaginal prolapse, urinary and fecal incontinence; 2. To test the contribution of ATFP/cardinal and their attached fascia (cystocoele repair), if any, to causation of fecal incontinence. PATIENTS AND METHODS. Eighty-one patients, mean age 60.1, mean weight 69 kg (43-112 kg), mean 2.0 previous pelvic operations, underwent 154 site specific operations in the 3 zones of the vagina as primary procedures using the Tissue Fixation System (TFS). The site of operation(s) was determined by reference to a pictorial diagnostic algorithm: pubourethral ligaments, n=43; ATFP, cardinal ligaments, (cystocoele) n = 39; uterosacral ligaments (apical prolapse), n = 72. The patients were assessed with a 24 hour urinary diary, structured questionnaire, transperineal ultrasound, urodynamics, cough stress test, and 24 hour pad test, pre and post-operatively at mean 12 months (6-18 months). RESULTS. Symptom improvement was as follows: fecal incontinence (n = 33) 88%, stress incontinence (n = 43) 89%, urgency and nocturia (n = 50) 80%. CONCLUSIONS. Both urinary and fecal incontinence (FI) symptoms were simultaneously cured, indicating a causal link. Repair of ATFP and cardinal ligament defects (cystocoele) did not produce a significantly higher cure rate for FI to that achieved by repairing just the anterior and/or posterior suspensory ligaments in studies No 9 & 10, indicating perhaps, the primacy of anterior and/or posterior suspensory ligaments in FI control.
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The Tissue Fixation System provides a new structural method for cystocoele repair: a preliminary report.
The Australian & New Zealand journal of obstetrics & gynaecology, 2006Co-Authors: Peter Petros, Peter Richardson, Klaus Goeschen, Burghard AbendsteinAbstract:Background: A new reconstruction principle that uses tensioned tapes instead of large mesh is described for cystocoele repair. Aim: To apply this method to patients with central, paravaginal and cervical ring defects. Methods: Ninety patients, mean age 63 years (29–83) and mean weight 73 kg (52–117 kg), underwent cystocoele repair using the Tissue Fixation System (TFS). Tapes were applied as a retro-obturator U-sling (n = 29), transversely between both arcus tendineus fascia pelvis (ATFP) ligaments (n = 45), along the path of the cardinal ligament in patients with cervical ring defects (n = 12), and longitudinally along the ATFP ligament (n = 4). Results: At mean eight months review (three to 15 months), two failures were reported. There was one haematoma that drained spontaneously at seven days, and there were no erosions. Mean hospital stay was one a half days for the Australian group (one to seven days) and five days (four to eight days) for the European group. After using single U-sling, one patient required intermittent catheterisation for seven days before she could pass urine freely. In one patient the bladder was perforated during dissection laterally towards the ATFP; the perforation was successfully repaired. Conclusions: The tensioned tape operation is simple and accurate, and appears to work well in the short term. Longer-term studies are required.
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midurethral Tissue Fixation system sling a micromethod for cure of stress incontinence preliminary report
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2005Co-Authors: Peter Petros, Peter RichardsonAbstract:Aims: To assess the effectiveness of the Tissue Fixation System (TFS) in patients with stress incontinence. The TFS uses two small plastic anchors to fix an (adjustable) midurethral polypropylene mesh sling into the soft Tissues below the pubic bone. Patients and methods: Thirty-six patients with stress incontinence, mean age 55 (35–87), mean weight 76 kg (33–117 kg), mean 0.8 previous operations for stress incontinence, underwent a TFS midurethral sling operation. The patients were preoperatively assessed with a structured questionnaire, 24-h urinary diary, cough stress test, transperineal ultrasound, and urodynamics. Using the TFS delivery system, a midurethral mesh tape was attached to the fibromuscular Tissues behind the perineal membrane. The suburethral vaginal fascia was also tightened. Post-operatively. the patients were reviewed at 6 weeks, and at 3-monthly intervals with ultrasound, and cough stress tests. Results: Primary symptomatic cure rate at mean 9 months (3–15 months) was 83.4% (n = 36). Pad test loss decreased from a mean 12.7 g to a mean of 0.2 g; mean operating time was 5 min, and mean hospital stay was 24 h (12–48 h). There were no cases of obstructed micturition, and minimal analgesia only was required postoperatively. Conclusion: The TFS is a promising new method. The results at this stage are similar to those achieved previously with the ‘tension-free’ tape operations, but with greater safety and shorter operating time. Testing by other surgeons will be required to evaluate this method further.
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Tissue Fixation system posterior sling for repair of uterine vault prolapse a preliminary report
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2005Co-Authors: Peter Petros, Peter RichardsonAbstract:Aims: To assess the posterior Tissue Fixation System (TFS) sling for repair of uterine/vault prolapse. Patients and methods: The TFS comprises of two small polypropylene soft Tissue anchors connected to an adjustable polypropylene tape. The posterior TFS sling works much like a McCall procedure. The anchors are inserted just lateral to the uterosacral ligaments. Tightening the sling elevates the prolapsed uterus/vaginal vault. The study group comprised 67 patients who were assessed with a 24-h urinary diary, structured questionnaire, transperineal ultrasound, urodynamics, cough stress test, and 24-h pad test, pre and postoperatively. Results: Sixty-seven patients, mean age 65 years (35–87), mean weight 71 kg (38–117 kg), mean 1.6 previous pelvic operations, underwent posterior sling (level 1) repair for uterine/vault prolapse (fourth degree: n = 2; third degree: n = 17; second degree: n = 20; symptomatic first degree: n = 28). Level 2 (n = 18) and level 3 repairs (n = 18) were also performed as required. One patient was lost to the study. At mean 9 months’ review (3–15 months), the prolapse repair had been successful in all but one patient. There were however, 14 de novo herniations postoperatively (20%), cystocoele 12, enterocoele 1, rectocoele 1. Operating time for the sling only was 5–10 min, and mean hospital stay was 1.5 days. Minimal analgesia was required. Conclusions: The preliminary results indicate that the TFS posterior sling appears to work well in patients with uterine/vault prolapse. Longer term follow up and studies by other surgeons are required to fully evaluate this procedure.
Yuki Sekiguchi - One of the best experts on this subject based on the ideXlab platform.
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Retropubic Tissue Fixation system tensioned mini-sling carried out under local anesthesia cures stress urinary incontinence and intrinsic sphincter deficiency: 1-year data.
International journal of urology : official journal of the Japanese Urological Association, 2017Co-Authors: Ryoko Nakamura, Masahiro Yao, Yoshiko Maeda, Akiko Fujisaki, Yuki SekiguchiAbstract:Objectives To assess the outcomes of the Tissue Fixation system midurethral sling for the treatment of intrinsic sphincter deficiency. Methods We retrospectively studied a total of 96 intrinsic sphincter deficiency patients treated with the Tissue Fixation system midurethral sling at Yokohama Motomachi Women's Clinic from 2006 to 2015. We evaluated intraoperative and 1-year postoperative results. Regarding the cure rate, we divided patients into three groups: (i) patients with maximum urethral closure pressure
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Outpatient mid-urethral Tissue Fixation system sling for urodynamic stress urinary incontinence: 3-year surgical and quality of life results.
International urogynecology journal, 2017Co-Authors: Ryoko Nakamura, Masahiro Yao, Yoshiko Maeda, Akiko Fujisaki, Yuki SekiguchiAbstract:Introduction To evaluate the clinical effectiveness and quality of life (QOL) of outpatient mid-urethral Tissue Fixation system sling (TFS) procedures for urodynamic stress urinary incontinence (SUI) at 3-year follow-up.
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Outpatient mid urethral Tissue Fixation system sling for urodynamic stress urinary incontinence: 1-year results.
The Journal of urology, 2009Co-Authors: Yuki Sekiguchi, Manami Kinjyo, Hiromi Inoue, Hisaei Sakata, Yoshinobu KubotaAbstract:Purpose: We tested the feasibility of using the Tissue Fixation system to create a mid urethral sling for urodynamic stress urinary incontinence at a freestanding outpatient facility. The Tissue Fixation system is a new mini sling device with a 1-way tightening system.Materials and Methods: We performed 44 mid urethral Tissue Fixation system sling operations between December 2006 and March 2008 at Yokohama Motomachi Women's Clinic LUNA. All patients had urodynamic stress urinary incontinence, as proven by preoperative urodynamics.Results: Mean ± SD patient age was 58.2 ± 11.9 years. Surgery was done on an outpatient basis using local anesthesia. Postoperative pain was minimal. All patients were discharged home the same day. Mean operative time, including local anesthesia administration, was 24.5 ± 7.7 minutes (median 25, range 15 to 50). Mean blood loss was 17.7 ± 21.7 ml (median 5, range 3 to 98). Five patients who could not pass urine within 8 hours were discharged home with an indwelling Foley catheter...
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Tissue Fixation system tfs to repair uterovaginal prolapse with uterine preservation a preliminary report on perioperative complications and safety
Journal of Obstetrics and Gynaecology Research, 2009Co-Authors: Hiromi Inoue, Yuki Sekiguchi, Yutaka Kohata, Yuka Satono, Kenji Hishikawa, Toyoko Tominaga, Mika OobayashiAbstract:Objectives: To assess the effectiveness, perioperative safety and invasiveness of the Tissue Fixation System (TFS) sling operation when used for repair of uterovaginal prolapse with uterine preservation. Methods: Operations using the TFS anchor system were performed on 25 women aged between 44 and 84 years (average 65) for grade 3 or 4 uterine prolapse with or without urinary incontinence. Details of the procedures were as follows: midurethral sling (n = 2); posterior sling of the uterosacral ligaments (n = 25); U-sling for lateral/central anterior vaginal wall defects (n = 24). The defect of the perineal body and rectovaginal fascia were repaired in all cases. Results: All patients were followed up for a minimum of 3 months. The mean ± standard deviation of the operating time and loss of blood were 94.2 (±19.3) minutes and 98.1 (±129.6) mL, respectively. Twelve patients (48%) were discharged on the same day of surgery and 13 patients (52%) on the following day, with a return to normal activities within 1–7 days. There were no intra- or postoperative complications. At the 3-month follow up, cure rates of symptoms due to pelvic laxity were: urinary frequency 85.7% (n = 14); nocturia 66.6% (n = 12); urgency 93.3% (n = 15); and dragging pain 100% (n = 6). There was one recurrent uterovaginal prolapse and one recurrent cystocele. Conclusion: The TFS procedure delivers satisfactory results for uterine prolapse repair with uterine preservation. The procedure is useful because of the short duration of the operation, the short term of recovery, its safety profile and minimal invasiveness. There is a significant improvement in the quality of life, especially for older women. However, long-term results are currently unknown.
Karl-friedrich Becker - One of the best experts on this subject based on the ideXlab platform.
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Delayed times to Tissue Fixation result in unpredictable global phosphoproteome changes.
Journal of proteome research, 2013Co-Authors: Sibylle Gündisch, Kathrin Grundner-culemann, Claudia Wolff, Christina Schott, Bilge Reischauer, Manuela Machatti, Daniel Groelz, Christoph Schaab, Andreas Tebbe, Karl-friedrich BeckerAbstract:Protein phosphorylation controls the activity of signal transduction pathways regulated by kinases and phosphatases. Little is known, however, about the impact of preanalytical factors, for example, delayed times to Tissue Fixation, on global phosphoprotein levels in Tissues. The aim of this study was to characterize the potential effects of delayed Tissue preservation (cold ischemia) on the levels of phosphoproteins using targeted and nontargeted proteomic approaches. Rat and murine liver samples were exposed to different cold ischemic conditions ranging from 10 to 360 min prior to cryopreservation. The phosphoproteome was analyzed using reverse phase protein array (RPPA) technology and phosphoprotein-enriched quantitative tandem mass spectrometry (LC-MS/MS). RPPA analysis of rat liver Tissues with long (up to 360 min) cold ischemia times did not reveal statistically significant alterations of specific phosphoproteins even though nonphosphorylated cytokeratin 18 (CK18) showed increased levels after 360 min of delay to freezing. Keeping the samples on ice prior to cryopreservation prevented this effect. LC-MS/MS-based quantification of 1684 phosphorylation sites in rat liver Tissues showed broadening of their distribution compared to time point zero, but without reaching statistical significance for individual phosphosites. Similarly, RPPA analysis of mouse liver Tissues with short (
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delayed times to Tissue Fixation result in unpredictable global phosphoproteome changes
Journal of Proteome Research, 2013Co-Authors: Sibylle Gündisch, Claudia Wolff, Christina Schott, Bilge Reischauer, Manuela Machatti, Daniel Groelz, Christoph Schaab, Andreas Tebbe, Kathrin Grundnerculemann, Karl-friedrich BeckerAbstract:Protein phosphorylation controls the activity of signal transduction pathways regulated by kinases and phosphatases. Little is known, however, about the impact of preanalytical factors, for example, delayed times to Tissue Fixation, on global phosphoprotein levels in Tissues. The aim of this study was to characterize the potential effects of delayed Tissue preservation (cold ischemia) on the levels of phosphoproteins using targeted and nontargeted proteomic approaches. Rat and murine liver samples were exposed to different cold ischemic conditions ranging from 10 to 360 min prior to cryopreservation. The phosphoproteome was analyzed using reverse phase protein array (RPPA) technology and phosphoprotein-enriched quantitative tandem mass spectrometry (LC-MS/MS). RPPA analysis of rat liver Tissues with long (up to 360 min) cold ischemia times did not reveal statistically significant alterations of specific phosphoproteins even though nonphosphorylated cytokeratin 18 (CK18) showed increased levels after 360 min of delay to freezing. Keeping the samples on ice prior to cryopreservation prevented this effect. LC-MS/MS-based quantification of 1684 phosphorylation sites in rat liver Tissues showed broadening of their distribution compared to time point zero, but without reaching statistical significance for individual phosphosites. Similarly, RPPA analysis of mouse liver Tissues with short (<60 min) cold ischemia times did not reveal directed or predictable changes of protein and phosphoprotein levels. Using LC-MS/MS and quantification of 791 phosphorylation sites, we found that the distribution of ratios compared to time point zero broadens with prolonged ischemia times, but these were rather undirected and diffuse changes, as we could not detect significant alterations of individual phosphosites. On the basis of our results from RPPA and LC-MS/MS analysis of rat and mouse liver Tissues, we conclude that prolonged cold ischemia results in unspecific phosphoproteome changes that can be neither predicted nor assigned to individual proteins. On the other hand, we identified a number of phosphosites which were extraordinarily stable even after 360 min of cold ischemia and, therefore, may be used as general reference markers for future companion diagnostics for kinase inhibitors.
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Histological Assessment of PAXgene Tissue Fixation and Stabilization Reagents
PloS one, 2011Co-Authors: Marcel Kap, Bilge Reischauer, Daniel Groelz, Karl-friedrich Becker, Frank Smedts, Wolter Oosterhuis, Rosa Winther, Nanna Christensen, Christian Viertler, Kurt ZatloukalAbstract:Within SPIDIA, an EC FP7 project aimed to improve pre analytic procedures, the PAXgene Tissue System (PAXgene), was designed to improve Tissue quality for parallel molecular and morphological analysis. Within the SPIDIA project promising results were found in both genomic and proteomic experiments with PAXgene-fixed and paraffin embedded Tissue derived biomolecules. But, for this technology to be accepted for use in both clinical and basic research, it is essential that its adequacy for preserving morphology and antigenicity is validated relative to formalin Fixation. It is our aim to assess the suitability of PAXgene Tissue Fixation for (immuno)histological methods. Normal human Tissue specimens (n = 70) were collected and divided into equal parts for Fixation either with formalin or PAXgene. Sections of the obtained paraffin-embedded Tissue were cut and stained. Morphological aspects of PAXgene-fixed Tissue were described and also scored relative to formalin-fixed Tissue. Performance of PAXgene-fixed Tissue in immunohistochemical and in situ hybridization assays was also assessed relative to the corresponding formalin-fixed Tissues. Morphology of PAXgene-fixed paraffin embedded Tissue was well preserved and deemed adequate for diagnostics in most cases. Some antigens in PAXgene-fixed and paraffin embedded sections were detectable without the need for antigen retrieval, while others were detected using standard, formalin Fixation based, immunohistochemistry protocols. Comparable results were obtained with in situ hybridization and histochemical stains. Basically all assessed histological techniques were found to be applicable to PAXgene-fixed and paraffin embedded Tissue. In general results obtained with PAXgene-fixed Tissue are comparable to those of formalin-fixed Tissue. Compromises made in morphology can be called minor compared to the advantages in the molecular pathology possibilities.
Stephen S. Burkhart - One of the best experts on this subject based on the ideXlab platform.
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Loop Security as a Determinant of Tissue Fixation Security
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 1998Co-Authors: Stephen S. Burkhart, Michael A. Wirth, Matthew Simonick, Daniel Salem, Dan R. Lanctot, Kyriacos A. AthanasiouAbstract:Abstract Secure arthroscopic repair of rotator cuff tears and Bankart lesions requires tight knots (knot security). Equally important, but usually overlooked, is the tightness of the suture loop (loop security). This study compared loop security in knots tied with No. 1 PDS suture using three different methods: (1) hand-tied, (2) single-hole standard knot pusher, and (3) cannulated double-diameter knot pusher. The results of this study show that the double-diameter knot pusher maintained tight suture loops that were equivalent in circumference to hand-tied loops and were significantly tighter than suture loops tied with a standard single-hole knot pusher. This study highlights the fact that loop security is equally important to knot security in Tissue Fixation. Arthroscopy 1998 Oct;14(7):773-6
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Tissue Fixation security in transosseous rotator cuff repairs: A mechanical comparison of simple versus mattress sutures
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 1996Co-Authors: Stephen S. Burkhart, Scott P. Fischer, Wesley M. Nottage, James C. Esch, F. Alan Barber, David Doctor, James FerrierAbstract:The primary purpose of this investigation was to compare Tissue Fixation security by simple sutures versus mattress sutures in transosseous rotator cuff repair. These two repair techniques were each performed in 17 human cadaver shoulders, with two bone tunnels being used for the repair by two simple sutures and two other bone tunnels being used for the repair by one mattress suture. The repairs were loaded to failure in a servohydraulic materials test system. Rotator cuff repair by simple sutures was found to be significantly stronger than repair by mattress sutures (P = .0007). The average ultimate load to failure for the simple suture construct (189.62 N) was 39.72% greater than that for the mattress suture construct (135.71 N). Most of the failures occurred by suture breakage at the knot. Load-sharing by multiple suture tails and multiple knots in the simple suture configuration likely contributed to its superior strength characteristics compared with the mattress suture configuration.
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Tissue Fixation security in transosseous rotator cuff repairs: A mechanical comparison of simple versus mattress sutures
Journal of Shoulder and Elbow Surgery, 1996Co-Authors: Stephen S. BurkhartAbstract:Summary: The primary purpose of this investigation was to compare Tissue Fixation security by simple sutures versus mattress sutures in transosseous rotator cuff repair. These two repair techniques were each performed in 17 human cadaver shoulders, with two bone tunnels being used for the repair by two simple sutures and two other bone tunnels being used for the repair by one mattress suture. The repairs were loaded to failure in a servohydraulic materials test system. Rotator cuff repair by simple sutures was found to be significantly stronger than repair by mattress sutures (P = .0007). The average ultimate load to failure for the simple suture construct (189.62 N) was 39.72% greater than that for the mattress suture construct (135.71 N). Most of the failures occurred by suture breakage at the knot. Load-sharing by multiple suture tails and multiple knots in the simple suture configuration likely contributed to its superior strength characteristics compared with the mattress suture configuration. Key Words: Rotator cuff--Tendon repair--Suture strength--Ultimate strength--Biomechanical testing.
