Improving Visualization via Polytetrafluoroethylene Mesh in 3D Computed Tomography Imaging After Laparoscopic Sacrocolpopexy.

Objectives: Non-radiolucent polytetrafluoroethylene (PTFE) mesh is used in transvaginal mesh (TVM) surgery and laparoscopic sacrocolpopexy (LSC) in Japan. Although a previous study demonstrated PTFE mesh visualization using computed tomography (CT) after TVM, its visualization in LSC remains unclear. This study aimed to use CT to quantify PTFE mesh visualization after LSC and determine whether three-dimensional (3D) mesh visualization could be achieved.

Methods: This retrospective multicenter study included 107 patients who underwent LSC at one of four institutions between June 2021 and November 2022, with CT imaging being performed over 6 weeks postoperatively. Three-dimensional CT images were generated using SYNAPSE VINCENT software. Three assessors assessed visualization rates for three mesh parts (arm, anterior body, posterior body), with the anterior and posterior bodies being divided into four sections. Visualization was scored using a 5-point scale (0: invisible to 4: 100% visible).

Results: The median visualization rates were 4.0 (3.7-4.0) for the arm, 3.3 (3.1-3.6) for the anterior body, and 2.5 (2.3-2.8) for the posterior body. Three-dimensional images were successfully obtained in all cases. The anterior body showed significantly higher visualization rates on the distal side, while the posterior body exhibited no significant differences across sections.

Conclusions: CT demonstrated high visualization rates for PTFE mesh implanted during LSC, particularly for the arm and anterior body. Complete 3D CT visualization of the PTFE mesh was achieved in all cases.