Long unidirectional barbed suturing technique with extracorporeal traction in laparoscopic myomectomy

Abstract

BackgroundMyomectomy is now often performed laparoscopically rather than by laparotomy to alleviate the risk of postoperative adhesions and reduce postoperative pain. However, intracorporeal knot-tying under direct laparoscopy is difficult and requires proficiency. We conducted a retrospective study comparing the results of a long unidirectional barbed suturing technique (with V-Loc180 suture) and the results of conventional suturing as applied to laparoscopic myomectomy.MethodsIn women who underwent laparoscopic myomectomy in our university hospital between January 2011 and April 2013, uninterrupted suturing of 2 or more layers was performed. These women were divided into 2 groups according to the method of suturing: those in whom standard absorbable sutures were used (group P, n =42) and those in whom our suturing technique was used (group V, n =41). Patient characteristics and surgical variables were compared between the 2 groups.ResultsNo significant between-group difference was observed in age (p = .975), body mass index (p = .778), GnRHa administration (p = .059), intraoperative vasopressin dose (p = .364), intraoperative blood loss (73.8 ± 64.1 vs. 59.3 ± 54.0 mL, respectively; p = .199), myoma mass (212.6 ± 133.3 vs. 208.3 ± 198.4 g, respectively; p = .134), ΔHb (p = .517), or postoperative hospital stay (p = .314). Operation time (mean ± SD) was significantly shorter for group V (71.2 ± 22.9 minutes; range, 28.0–110.0 minutes; p < .001) than for group P (94.4 ± 27.2 minutes; range, 53.0–165.0 minutes). No patient required intraoperative transfusion or conversion to laparotomy.ConclusionsOur suturing technique exploits the features of unidirectional barbed sutures and can be used in the same way as the conventional method when performing continuous suturing for laparoscopic myomectomy. Our data suggest that operation time can be reduced by as much as 25% with this new technique.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2482-14-84) contains supplementary material, which is available to authorized users.

RETRACTED ARTICLE: Use of Barbed Sutures in Bariatric Surgery. Review of the Literature

“…Barbed sutures have been used over recent years in different fields such as gynecology [10,11,17,[19][20][21], urology [22][23][24], orthopedic surgery [25,26], and plastic surgery [27][28][29]. Regarding general and digestive surgery, the use of barbed sutures has been recently reported in colorectal surgery, where they have been used safely in closure of the pelvic cavity after abdominoperineal resection [30].…”

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

“…According to a retrospective trial conducted by Aoki et al [29], the mean total operative time was significantly shorter in the barbed suture arm than in the conventional suture one. No significant differences were reported in relation to age, BMI, estimated blood loss/Hb drop, length of hospitalization, and weight of myoma(s).…”

Incidence of Postoperative Adhesions after Laparoscopic Myomectomy with Barbed Suture

“…Because of the potential risk of postoperative adhesion formation caused by BS, we use a baseball running suture for closure of the serosal layer of enucleated wounds to prevent exposing barbs to the serosal suturing surface as much as possible [15]. We compared the incidence of adhesions after using BS and conventional absorbable thread for closure of serosal layer during second-look laparoscopy (SLL).…”