Fascia Lata Harvest Research Articles

Entwicklung eines Operationsgerätes zur minimal-invasiven Fascia lata-Entnahme / Designing a surgical device for harvesting autologous fascia lata grafts as a minimal invasive procedure

Fascia lata is used in different shapes and sizes as a graft material in surgical procedures. The conventional method of harvesting a fascia lata graft is through a long skin incision on the lateral aspect of the thigh. Minimal invasive procedures have been established to reduce the disadvantages of an extensive surgical approach for obtaining the autotransplant. However, they do not facilitate to suture the remaining fascia after harvesting the transplant and therefore bear the risk of a symptomatic herniation of the muscle belly. The aim of this study was to design a surgical device to harvest a fascia lata graft and close the resulting fascia defect as a minimal invasive procedure. The prototype was tested in 11 human cadaver specimens. It was introduced subcutanously via two small skin incisions. The device contained a special fixation- and working mechanism which enabled the fascial closure using a continuous suture. After the harvest procedure, both the transplant and the sutured fascia lata were examined. The experiments demonstrated the suitability of this method for minimal invasive harvesting of fascia lata. The removed transplants complied in all experiments with the expected dimensions. The continuous suture of the femoral fascia ran with accurate gaps between the sutures and constant tension without dehiscence. Neither the transplant nor the tissue in the region of harvest have shown unduly macroscopic damage due to the use of the device. The designed prototype can be used for harvesting a fascia lata graft and repairing the resulting defect minimal invasively. Clinical implementation seems possible. However, improvements could be made mainly concerning the handling of the device.

Abdominal Sacral Colpopexy Using Autologous Fascia Lata

Numerous techniques and materials have traditionally been used to correct vaginal vault prolapse, including cadaveric fascia, synthetic materials and autologous rectus fascia. We report our experience with autologous fascia lata used for abdominal sacral colpopexy. A retrospective review identified all women who underwent abdominal sacral colpopexy using autologous fascia lata for vaginal vault prolapse with at least 18 months of followup. Preoperative and postoperative pelvic organ prolapse quantification (POP-Q) scores, relevant clinical and operative parameters, treatment efficacy, harvest site morbidity and patient satisfaction were assessed. Ten women underwent this procedure between 1999 and 2001. Mean patient age was 68.3 years (range 55 to 82). Followup was 19 to 42 months (mean +/- SD 30.5 +/- 7.78). Preoperatively POP-Q stages were II to IV in 3, 5 and 2 cases, respectively. Postoperative POP-Q scores improved to and remained at stage II or lower in all 10 patients. Mean operative time was 182 +/- 40.94 minutes (range 136 to 265). Mean blood loss was 107.5 +/- 50.07 cc (range 50 to 200). There was no morbidity associated with fascia lata harvest. Eight of the 9 women alive at review completed and returned the survey. When asked if they could return to how they were before surgery, would they still have the same procedure done and would they recommend the procedure to a friend, all respondents answered yes to each question. Autologous fascia lata compares favorably in efficacy to that reported for other materials in the contemporary literature and it is not associated with any significant morbidity.

Harvesting autologous fascia lata for pelvic reconstructive surgery: Techniques and morbidity

Objective: To determine donor site morbidity associated with harvesting of fascia lata. Study Design: We reviewed medical records and evaluated responses to mailed questionnaires from all patients who underwent fascia lata harvesting during a 54-month period. Data were collected about immediate complications and long-term morbidity related to the donor site. Results: The study comprised 71 patients. Immediate postoperative complications were limited to 1 (1%) hematoma that required drainage, 2 (3%) seromas, and 5 (7%) cases of cellulitis that required oral antibiotics. Questionnaire response rate was 77%, with a mean follow-up of 25 months. Of the responders, 22 (40%) reported mild symptoms, 3 (5%) reported clinically significant symptoms related to the donor leg, and 7 (13%) expressed dissatisfaction because of unacceptable cosmesis (n = 5), leg discomfort (n = 5), or both. Conclusion: There was little immediate postoperative morbidity. Although many patients may be expected to report long-term symptoms related to the donor leg, these symptoms are generally mild, and the incidence of patient dissatisfaction is relatively low. (Am J Obstet Gynecol 2001;185:1354-9.)

Long-Term Results of a Fascia Lata Suburethral Patch Sling for Severe Stress Urinary Incontinence

The suburethral sling created from a patch of the fascia lata has been used with success to treat recurrent or severe stress urinary incontinence. The authors reviewed their own experience with 46 patients who underwent this procedure between 1989 and 1995 to evaluate long-term results and outcomes related to continence and voiding dysfunction. All of the patients had confirmed genuine stress incontinence thought to be associated with intrinsic sphincter deficiency, and all had undergone a modified transvaginal fascia lata sling procedure as described by the authors of this article (Fig. 1). Thirty-six of the 46 patients could be found and consented to participate in a telephone interview using the Incontinence Impact Questionnaire/Urogenital Distress Inventory short form. The women were requested to return for a physical examination and evaluation; 24 agreed. The average length of time since surgery was 36 months (31 months for the women who returned for examination and 46 months for those who participated in the telephone interview only). The 36 women had a mean age of 53 years and an average parity of 3.4. The group had an overall objective cure rate (negative standing stress test at maximum bladder capacity) of 79 percent. Sixty-seven percent of those who returned for examination reported a subjective cure (mild or no stress-related incontinence on the Incontinence Impact Questionnaire/Urogenital Distress Inventory), compared with 83 percent of those who chose not to return (overall subjective cure rate for the group, 72 percent). Self-catheterization had continued for an average of less than 3 weeks for all patients. In the patients who returned for objective examination, a significant reduction in the maximum cotton swab angle (from a mean of 340 to 210 above the horizontal) had been achieved, and the bladder neck remained stabilized. However, 17 percent of the patients who were reexamined had a uterine prolapse to the level of the introitus. Nineteen of the 24 (79 percent) women in the reexamined group had an objective cure, but 35 percent of them reported moderate to severe stress and urge incontinence symptoms; overall, 32 percent of patients reported these symptoms. Of the five patients in whom signs of stress incontinence were present, two had moderate to severe urge incontinence symptoms, and another also had uninhibited detrusor activity during office cystometry. One patient who had cystometric detrusor instability preoper atively did not show any signs of stress incontinence or urge-related loss. Urinary tract infection confirmed by positive culture was seen in 5 of the 24 patients (21 percent) who returned for examination; one of these women was completely asymptomatic. Postvoid residuals at examination were similar for these patients and those without infection. More than half of the reexamined subjects had moderate to severe urge incontinence symptoms. One-third of these were positive for urinary tract infection, and half of this group had resolution of their urge incontinence symptoms after treatment for infection. Overall, 64 percent of participants reported moderate to severe urge incontinence symptoms. Overall, 72 percent of patients reported some degree of urge incontinence symptoms, and frustration with these symptoms was expressed by 42 percent. The level of frustration was the same in both the women who were reexamined and those who were not. Patients with objective stress incontinence had significantly increased maximum flow rates compared with those who showed no signs of stress incontinence. Average flow rates were similar for both groups. Eighty-six percent of the women who returned for examination had parabolic postoperative uroflow curves, 10 percent had intermittent uroflow curves, and 4 percent had obstructed uroflow curves. One patient developed an abdominal sinus tract after suprapubic trauma and underwent removal of the permanent sutures with no diminution of continence. Another women had a suprapubic cellulitis that was treated successfully with antibiotics, and a third developed a hernia at the fascia lata harvest site that was repaired with synthetic mesh. J Pelvic Surg 1999;5:196–202

High Leg Incision Fascia Lata Harvesting

The traditional method of harvesting fascia lata has been through an incision above the lateral knee. Problems with this method include a conspicuous scar, herniation of the muscle belly, and hematoma formation. The authors describe a new method of harvesting fascia lata in the region of the hip to minimize these complications. Cohort study. Twenty-three patients underwent harvesting of fascia lata by the technique described by the authors. Twenty-one patients had ptosis with poor levator function. In two patients, the fascia lata was used to wrap a hydroxyapatite implant. The technique for harvesting fascia lata through an incision between the greater trochanter and anterior iliac crest is described. Long-term results were collected from chart reviews and patient interviews after surgery. The patients were evaluated to determine whether any complications resulted from the new incision site. No permanent complications were noted at the incision site. Fascia lata can be harvested safely in the region of the iliac crest with an inconspicuous scar and with fewer complications than with the more traditional site slightly above the lateral knee.

Complications of fascia lata harvesting for ptosis surgery

AIMS/BACKGROUNDThe aim of this study was to assess the morbidity associated with harvesting autogenous fascia lata for brow suspension ptosis surgery.METHODSA retrospective study by postal questionnaire of 24 consecutive patients.RESULTSEarly...

Videoscopically Assisted Fascia Lata Harvest for the Correction of Recurrent Ventral Hernia

Autologous fascia lata tissue transfer is a feasible alternative to reconstruction of the abdominal wall in selected patients. We describe a new technique using minimally invasive technology that allows harvest of the fascia lata graft without the traditional large thigh incision.

High-Incision Harvesting of Fascia Lata From the Leg

High-Incision Harvesting of Fascia Lata From the Leg