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An anatomic comparison of the original versus a modified inside-out transobturator procedure

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Abstract

Introduction and hypothesis

The objective of this study was to evaluate the modification of a shortened tape and reduced dissection of the inside-out transobturator procedure on the tape’s relationship to the relevant anatomical structures.

Methods

In ten fresh frozen cadavers, relevant distances between the two different tapes and anatomical structures were recorded.

Results

The shorter tape traversed less muscular structures, but consistently traversed the obturator membrane. The median distance from the tape to the obturator canal measured 2.0 versus 1.9 cm, to the anterior obturator nerve 3.0 versus 2.7 cm, and to the posterior obturator nerve 2.2 versus 2.0 cm [modified versus original procedure, respectively (p > 0.05)]. Significantly, less mesh was inserted in the modified procedure on each side of the body (6.1 versus 9.9 cm, p < 0.05).

Conclusions

The shorter, inside-out transobturator tape traverses less muscular structures than its original counterpart, while still consistently anchoring in the obturator membrane at a similarly safe distance from the obturator canal.

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Acknowledgments

The authors wish to thank Dr. Christophe De Roover and Dr. Florie Gomez for their technical assistance during the dissections.

Conflicts of interest

Jean de Leval and David Waltregny are consultants for Ethicon. Piet Hinoul is an employee of Ethicon. This study received no funding from industry.

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Authors and Affiliations

  1. Department of Medical Affairs, Ethicon Women’s Health and Urology, 1, rue Camille Desmoulins-TSA 81002, 92787, Issy Les Moulineaux CEDEX 9, France

    Piet Hinoul

  2. Institute of Human Anatomy, University of Liège, Liège, Belgium

    Pierre Bonnet

  3. Department of Urology, University Hospital of Liège, CHU Sart Tilman Liège, 4000, Liège, Belgium

    Pierre Bonnet, David Waltregny & Jean de Leval

  4. Institute for the Care of Mother and Child, Podolske nabrezi 157, Prague, Czech Republic

    Ladislav Krofta

Authors
  1. Piet Hinoul
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  2. Pierre Bonnet
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  3. Ladislav Krofta
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  4. David Waltregny
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  5. Jean de Leval
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Corresponding author

Correspondence to Jean de Leval.

Additional information

Piet Hinoul and Pierre Bonnet contributed equally to this manuscript.

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Hinoul, P., Bonnet, P., Krofta, L. et al. An anatomic comparison of the original versus a modified inside-out transobturator procedure. Int Urogynecol J 22, 997–1004 (2011). https://doi.org/10.1007/s00192-011-1415-2

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  • DOI: https://doi.org/10.1007/s00192-011-1415-2

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