Exploring the morphometric properties and immunobiology of Human Fascia Lata as a biological graft in pelvic reconstructive surgery

Pelvic Organ Prolapse (POP) is a disorder with a growing incidence and hidden clinical burden of disease. At present, there are relatively few surgical grafts available to augment POP repair, despite the increasing need as the population ages. This is due to the commercial withdrawal of all transvaginal mesh, and the more recent withdrawal of all mesh for sacrocolpopexy (abdominal correction of usually apical prolapse). Human fascia lata (HFL) grafts have long been used for incontinence procedures, and more recently for sacrocolpopexy or graft augmented vaginal repair where synthetic mesh is contra-indicated or unavailable. However, there is insufficient data pertaining to the durability of HFL grafts when compared with mesh for sacrocolpopexy, which has demonstrated a low recurrence rate with long-term follow-up. Furthermore, the mechanical, morphological, cellular, matrix, and immunological properties of HFL are poorly understood. This project will directly compare the unique properties of fascial grafts with synthetic polypropylene mesh through histology, immunohistochemistry, immunofluorescence, scanning electron microscopy, biomechanical tensile testing and atomic force microscopy. In doing so, we hope to better characterize its long term implications and mechanisms driving its integration in the body, which is necessary before it is more generally adopted. The project involves a large immunology and pathology component. We welcome students from all background with innovative thinking and interest in interdisciplinary research contribute this project.