TiLOOP® LLS Dubuisson and LLS H Dubuisson


The titanised mesh implant TiLOOP® LLS Dubuisson is used for laparoscopic lateral suspension (LLS) for uterus preservation and the TiLOOP® LLS H Dubuisson after hysterectomy. Laparoscopic lateral suspension (LLS) according to Dubuisson results in safe, successful defect therapy in both the apical and anterior compartments. LLS offers an alternative to sacrocolpopexy.


Benefits

Safe  Compared to sacrocolpopexy, anchoring the mesh at the Os sacrum is no longer required. Therefore, the risk of injury in this area is avoided.1,2

  • No foreign material on the periosteum, no danger of periostitis
  • Lumbar pain is avoided
  • Iliac blood vessels, aorta, vena cava and ureter in the region of the promontory are not injured
  • Minimised risk of irritations or injuries of the hypogastric plexus
  • Minimal risk of gut-mesh adhesion
  • Minimal risk of erosion (Image: 1)

Anatomically and symptomatically successful

  • Cranial central rather than posterior apex suspension: physiological suspension compared to sacrocolpopexy
  • Tension-free lateral suspension without anchoring
  • In the anterior and apical compartments, 93.6 % success rate1 (Image: 2)
  • Minimal dyspareunia rate1,3
  • Positive effect on obstipation problems

Simple, standardised surgical technique

  • Minimal opening of the peritoneum
  • Simple sub peritoneal tunnelling, no anchoring of the mesh arms to ligamentous structures
  • No preparation of the sacral promontory or other ligamentous connections
  • Individual, tension-free adjustment of the mesh after lateral, extraperitoneal positioning of the mesh arms
Image: 1
Image: 2

Details

  • Titanised type 1a polypropylene mesh
  • Microporous: 1 mm pore size
  • Lightweight: 65g/m²
  • Monofilament fabric
  • Laser-cut, atraumatic edges
  • Non-resorbable

Practice

Route of mesh arms, front view
View from above
Side view
Side view with focus on mesh tongue (zoom)

Knowledge

In addition to the skills of the surgeon, the quality of the mesh material used determines the quality of a lasting and anatomically stable descensus repair. TiLOOP® mesh implants are made of type 1a polypropylene mesh (microporous & monofilaments) with a titanised, hydrophilic surface. Compared to simple polypropylene, this offers many advantages, which are already known in the use of titanised mesh implants for hernia surgery:

Increased cell vitality of fibroblasts through polypropylene surface titanisation

Application Range

  • Prolapse in the central and/or apical compartment
  • Central cystocele
  • Hysterocele
  • Prolapsed uterus
  • Vaginal prolapse after hysterectomy
  • Up to Grade IV

Manufacturer

pfm medical titanium gmbh

Südwestpark 42

90449 Nürnberg, Germany

Ordering Information

TiLOOP® LLS Dubuisson and LLS H Dubuisson
REFMarkingApplicationLengthVPE
6000745TiLOOP® LLS DubuissonFor uterus preservation51.5 cm1
6001358TiLOOP® LLS H DubuissonAfter hysterectomy51.5 cm1

Literature

1 Veit-Rubin, N., et al., Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients. Int Urogynecol J, 2017. 28(11): p. 1685-1693

2 Dubuisson, J.B., et al., Treatment of genital prolapse by laparoscopic lateral suspension using mesh: a series of 73 patients. J Minim.Invasive.Gynecol., 2008. 15(1): p. 49-55

3 Dubuisson, J., et al., Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh. Arch Gynecol Obstet, 2013. 287(2): p. 307-12