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

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.