Archives of Gynecology and Obstetrics

, Volume 299, Issue 5, pp 1337–1343 | Cite as

Laparoscopic pectopexy: a follow-up cyclic biomechanical analysis determining time to functional stability

  • A. Sauerwald
  • L. Langer
  • D. Ratiu
  • A. Prescher
  • M. Scaal
  • G. K. Noé
  • K. Wegmann
  • D. R. Bulian
  • C. EichlerEmail author
General Gynecology



Pectopexy, a laparoscopic method for prolapse surgery, showed promising results in previous transient testing by this group. It was shown that a single suture, yielding an ultimate load of 35 N, was equivalent to continuous suturing. This was demonstrated in an in vitro cadaver study. This transient data were used to establish an elastic stress–strain envelope. It was now possible to proceed to dynamic in vitro analysis of this surgical method to establish time to functional stability.


Cyclic testing of this fixation method was performed on human female embalmed cadaver (cohort 1) and fresh, non-embalmed cadaver (cohort 2) pelvises. The testing envelope was 5–25 N at a speed of 1 mm/s. 100 load regulated cycles were applied.


100 cycles were completed with each model; no overall system failure occurred. Steady state, i.e., functional stability was reached after 14.5 (± 2.9) cycles for the embalmed group and after 19.1 (± 7.2) cycles for the non-embalmed group. This difference was statistically significant p = 0.00025.


This trial showed in an in vitro cyclic testing of the pectopexy method that functional stability may be achieved after no more than 19.1 cycles of load exposure. When remaining within the established load envelope of below 25 N, patients do not need to fear global fixation failure. Testing did demonstrate differences in non-embalmed and embalmed cadaver testing. Embalmed cadaver testing tends to underestimate time to steady state by 26.3%.


Pectopexy Laparoscopic Dynamic In vitro Analysis Cyclic testing Biomechanical Biomechanic 


Author contributions

AS: project development and manuscript writing. LL: project development, data collection, and manuscript writing. DR: manuscript writing/editing. AP: data collection. MS: data collection. GKN: project development manuscript writing/editing. KW: data collection. DRB: manuscript writing/editing. CE: project development, data collection, and manuscript writing.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Gynecology and ObstetricsSt. Marien-HospitalDürenGermany
  2. 2.Breast Cancer CenterMunicipal Hospital HolweideCologneGermany
  3. 3.Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
  4. 4.Department of AnatomyRWTH Aachen UniversityAachenGermany
  5. 5.Department of AnatomyUniversity of CologneCologneGermany
  6. 6.Department of Gynecology and ObstetricsHospital Rhein-Kreis-Neuss, Faculty University of Witten/HerdeckeWittenGermany
  7. 7.Center for Orthopedic and Trauma SurgeryUniversity Medical CenterCologneGermany
  8. 8.Department of Abdominal, Vascular and Transplant Surgery Cologne-Merheim Medical Center (CMMC)Witten/Herdecke UniversityWittenGermany
  9. 9.Brustzentrum der Universitätsfrauenklinik KölnCologneGermany

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