Laparoscopic Technique and Initial Experience with Knotless, Unidirectional Barbed Suture Closure for Staple-Conserving, Delta-Shaped Gastroduodenostomy after Distal Gastrectomy

Lee, Sang‐Woong; Nomura, Eiji; Tokuhara, Takaya; Kawai, Masaru; Matsuhashi, Nobuhisa; Yokoyama, Kazutake; Fujioka, Hiroya; Hiramatsu, Masako; Okuda, Jun; Uchiyama, Kazuhisa

doi:10.1016/j.jamcollsurg.2011.09.004

Cited by 43 publications

(31 citation statements)

References 22 publications

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“…The safety and efficacy of barbed suture use for closure of the exit hole after gastroduodenostomy in gastrectomy has been reported [2]. In addition to the benefits of barbed suture use, complications following use of these devices have been reported in the literature for several other surgeries [134].…”

Section: Discussionmentioning

confidence: 99%

Postoperative mechanical small bowel obstruction induced by V-Loc barbed absorbable suture after laparoscopic distal gastrectomy

et al. 2017

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When performing laparoscopic gastrectomy, suturing the intestinal anastomosis presents one of the greatest challenges. The V-Loc unidirectional barbed suture has been introduced to eliminate the need to tie knots during closure. This device offers a fast, secure, and effective alternative to conventional suture repair during laparoscopic surgery. However, there have been reported cases of surgical complications associated with the use of barbed suture devices. We describe here a case of small bowel obstruction resulting from improper use of barbed suture during total laparoscopic distal gastrectomy performed for gastric cancer. Following diagnosis of small bowel obstruction, the patient underwent immediate laparoscopic repair that identified the cause and relieved the small bowel obstruction. This case highlights the need for surgeons to carefully perform proper suturing technique in order to prevent complications. Surgeons should maintain a high index of suspicion for diagnosing and treating potentially severe complications when using barbed sutures.

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Section: Discussionmentioning

confidence: 99%

Postoperative mechanical small bowel obstruction induced by V-Loc barbed absorbable suture after laparoscopic distal gastrectomy

et al. 2017

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“…Further advancements in laparoscopic techniques and instrumentation are necessary for the development of the laparoscopic gastrectomy procedure. Among these developments, the clinical efficacy and suitability of knotless barbed absorbable suture has been reported to facilitate intestinal anastomosis in the past [[15], [16], [17]]. One of these novel sutures, the V-Loc is a self-anchoring unidirectional barbed suture that obviates the need for tying knots.…”

Section: Discussionmentioning

confidence: 99%

“…One end of the V-Loc is a surgical needle while the other end is loop to enable avoidance of the need to tie a surgical knot. Although several reports of this device's use for laparoscopic gastrectomy have recently been proposed [[15], [16], [17], [18], [19]], there have been no reports for its incorporation during esophagogastrostomy closure, especially with hinged double ﬂap method.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic proximal gastrectomy with hinged double flap method using knotless barbed absorbable sutures: A case series

Saeki

Tanabe

Yamamoto

et al. 2018

International Journal of Surgery Case Reports

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“…2) (20), but Roux-en-Y reconstruction, which incorporated totally mechanical gastrojejunostomy with intracorporeal side-to-side jejunojejunostomy, was applied for patients with a small remnant stomach ( Fig. 3) (14,(26)(27)(28); (ii) after PPG, Billroth I gastrogastrostomy by the delta-shaped method was performed; (iii) after TG, Roux-en-Y reconstruction, which consists of intracorporeal side-to-side esophagojejunostomy and intra-or extracorporeal side-to-side jejunojejunostomy, was performed; (iv) after PG, the double-tract method, which consists of intracorporeal side-to-side esophagojejunostomy and extracorporeal gastrojejunostomy and jejunojejunostomy via an umbilical minilaparotomy, was performed; (v) after LR, a two-layered continuous technique for gastrotomy closure using a barbed suture was performed.…”

Section: Operative Proceduresmentioning

confidence: 99%

“…We previously described our technique and initial experience from intracorporeal staple-conserving, deltashaped gastroduodenostomy after distal gastrectomy in 2011, including the first use of barbed sutures for gastrointestinal suturing (20). There are some reports on the use of barbed sutures in digestive surgery to date, but there have been no prospective reports of bowel anastomosis in laparoscopic gastric surgery for malignant disease (21)(22)(23)(24).…”

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confidence: 99%

Laparoscopic gastrointestinal anastomoses using knotless barbed absorbable sutures are safe and reproducible: a single-center experience with 242 patients

Lee

Kawai

Tashiro

et al. 2016

Jpn. J. Clin. Oncol.

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Objective: Intracorporeal reconstruction of the digestive tract is technically challenging. The V-Loc 180 wound closure device (Covidien) is a self-anchoring unidirectional barbed suture that obviates the need for knot tying. The aim of this prospective cohort study was to investigate the use of the novel suture in gastrointestinal enterotomy closure. Methods: The subjects comprised patients with malignant disease who were scheduled to undergo laparoscopic gastrectomy with curative intent. The barbed suture was used to close the entry hole for the linear stapler during intracorporeal reconstruction following laparoscopic gastric resection. The primary endpoint was the proportion of patients who developed anastomotic leakage at the site where the barbed suture was applied. Results: Between July 2012 and March 2015, 242 patients were enrolled. Of 362 anastomoses, the enterotomy hole at 256 sites was closed using the barbed suture. These 256 sites consisted of 95 gastroduodenostomies, 25 gastrogastrostomies, 13 gastrojejunostomies, 90 jejunojejunostomies, 17 esophagojejunostomies and 16 primary closures of the stomach following local gastric resection. There were no anastomosis-related complications, conversion to usual sutures, mechanical closure of the entry hole and reoperation due to adhesive obstructions or mortality over a median follow-up period of 17.8 months.Conclusions: The use of the unidirectional barbed absorbable suture for gastrointestinal closure is safe and effective in laparoscopic gastrectomy.

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Laparoscopic Technique and Initial Experience with Knotless, Unidirectional Barbed Suture Closure for Staple-Conserving, Delta-Shaped Gastroduodenostomy after Distal Gastrectomy

Cited by 43 publications

References 22 publications

Postoperative mechanical small bowel obstruction induced by V-Loc barbed absorbable suture after laparoscopic distal gastrectomy

Postoperative mechanical small bowel obstruction induced by V-Loc barbed absorbable suture after laparoscopic distal gastrectomy

Laparoscopic proximal gastrectomy with hinged double flap method using knotless barbed absorbable sutures: A case series

Laparoscopic gastrointestinal anastomoses using knotless barbed absorbable sutures are safe and reproducible: a single-center experience with 242 patients

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