title: Arc-to-Arc mini-sling 1999: a critical analysis of concept and technology.
abstract: OBJECTIVE
  The aim of this study was to critically review the Arc-to-Arc mini-sling (Palma's technique) a less invasive mid-urethral sling using bovine pericardium as the sling material.
  
  
  METHODS
  The Arc-to-Arc mini-sling, using bovine pericardium, was the first published report of a mini-sling, in 1999. The technique was identical to the "tension-free tape" operation, midline incision and dissection of the urethra. The ATFP (white line) was identified by blunt dissection, and the mini-sling was sutured to the tendinous arc on both sides with 2 polypropylene 00 sutures.
  
  
  RESULTS
  The initial results were encouraging, with 9/10 patients cured at the 6 weeks post-operative visit. However, infection and extrusion of the mini-sling resulted in sling extrusion and removal, with 5 patients remaining cured at 12 months.
  
  
  CONCLUSIONS
  The Arc-to-Arc mini-sling was a good concept, but failed because of the poor technology available at that time. Further research using new materials and better technology has led to new and safer alternatives for the management of stress urinary incontinence.
authors.affiliation: Department of Urology, UNICAMP, Sao Paulo, Brazil. ppalma@uol.com.br
authors.forename: Paulo
authors.initials: P
authors.lastname: Palma
mesh_terms: D000818:Animals; D002417:Cattle; D006801:Humans; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D053825:Suburethral Slings / Q000009:adverse effects; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*