Evidence map›Paper›PMID 23299138›Full record

ArticleSurgical endoscopy2013

Laparoscopic mechanical fixation devices: does firing angle matter?

Emmanuel E Sadava, David M Krpata, Yue Gao, Steve Schomisch, Michael J Rosen, Yuri W Novitsky

Abstract readComparative StudyEvaluation Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Emmanuel E SadavaCase Comprehensive Hernia Center, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-5047, USA.
David M Krpata
Yue Gao
Steve Schomisch
Michael J Rosen
Yuri W Novitsky
Hernia Center · USUniversity Hospitals Case Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA variety of permanent and absorbable tacks are available for mesh fixation during laparoscopic hernia repairs. Although manufacturers recommend deploying tacks perpendicular to the tissue, achieving this can sometimes be challenging. This study aimed to analyze comparatively the effects of angled deployment among commonly used tacks.

methodsA piece of composite mesh was fixed to the peritoneal surface of a pig with a single tack fired at either a perpendicular (90°) or acute (30°) angle. A lap-shear test was performed to determine fixation strength. Two permanent tacks (a titanium spiral tack: Protack [PT]; and a hollow screw fastener: PermaFix [PF]) and three absorbable tackers (a solid screw: Absorbatack [AT]; a hollow screw fastener: SorbaFix [SF]; and a strap: SecurStrap [SS]) were challenged. A total of 16 samples were performed for each device at each angle. A nonabsorbable transfascial suture was used as a control condition.

resultsTransabdominal sutures had the maximum acute tensile strength (ATS) (29.9 ± 5.5 N). Protack at both 90° and 30° performed significantly better than absorbable tacks (p < 0.01). No significant difference was found among absorbable tacks at 90°. When the same construct was compared at different angles, SS and SF performance was not affected (p = 0.07 and 0.2, respectively). In contrast, PT and AT had significantly reduced fixation strength (p = 0.003 and 0.004, respectively). However, PT fired at an acute angle had fixation equal to that of absorbable tacks fired perpendicularly.

conclusionTransabdominal sutures performed better than tacks in the acute setting. No absorbable fixation device demonstrated superior efficacy within its class. Spiral titanium tacks provided better fixation than absorbable tacks at both perpendicular and acute angles. Moreover, titanium spiral tacks deployed at 30° performed equal to or better than absorbable tacks fired perpendicularly to the tissue. It appears that spiral titanium tacks should be strongly considered for cases in which perpendicular tack deployment cannot be achieved.

Indexed as

Surgical MeshSurgical StaplersSuturesAnimalsEquipment DesignHernia, VentralHerniorrhaphyLaparoscopySus scrofaTensile Strength

Identifiers

PMID23299138
OpenAlexW2070063457

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.