Small bowel obstructions following the use of barbed suture: a review of the literature and analysis of the MAUDE database

Clapp, Benjamin; Klingsporn, William; Lodeiro, Carlos; Wicker, Ellen; Christensen, Loyd; Jones, Robert; Tyroch, Alan

doi:10.1007/s00464-019-06890-z

Cited by 24 publications

(22 citation statements)

References 27 publications

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“…Absorbable barbed sutures do not require knots, which simplifies peritoneal suturing and shortens the operating time. In recent years, they have been widely used in TAPP and other procedures[ 7 ]. However, if used improperly, the barbs may be attached to the adjacent small intestine, mesentery, or omentum, causing complications such as abdominal adhesions, volvulus, and intestinal obstruction[ 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Man¹,

Li²,

Zhang³

et al. 2021

WJCC

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BACKGROUND Compared with open mesh repair, transabdominal preperitoneal (TAPP) hernioplasty results in less chronic postoperative inguinal pain and faster postoperative recovery. However, it may still lead to rare but serious complications. Here we report a case of intestinal volvulus with recurrent abdominal pain as the only clinical symptom, which occurred 3 mo after TAPP repair for bilateral inguinal hernia. CASE SUMMARY A 50-year-old male patient underwent laparoscopic TAPP for bilateral inguinal hernias. After the operation, he experienced recurring pain in his lower right abdomen around the surgical area, which was relieved after symptomatic treatment. Three months after the surgery, the abdominal pain became severe and was aggravated over time. The whirlpool sign of the mesentery was seen on contrast-enhanced computed tomography (CT). Laparoscopic exploration confirmed that a barb of the V-Loc™ suture penetrated the peritoneum, which caused the adhesion of the small intestinal wall to the site of peritoneal injury, forming intestinal volvulus. Since there was no closed-loop obstruction or intestinal ischemia, recurrent abdominal pain became the only clinical manifestation in this case. After laparoscopic lysis of adhesions and reduction of intestinal volvulus, the patient recovered and was discharged. CONCLUSION The possibility of intestinal volvulus should be considered in patients who experience recurrent abdominal pain following TAPP surgery during which barbed V-Loc sutures are used for closing the peritoneum. Contrast-enhanced CT and active laparoscopic exploration can confirm the diagnosis and prevent serious complications.

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Section: Discussionmentioning

confidence: 99%

“…It has been reported that the incidence of such complications following TAPP ranges from 0.2% to 0.5%[ 5 , 6 ]. Complications often occur within 2 wk after surgery, with abdominal pain and vomiting being the typical clinical manifestations[ 7 ]. These complications are rare but require a second operation.…”

Section: Introductionmentioning

confidence: 99%

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Man¹,

Li²,

Zhang³

et al. 2021

WJCC

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“…It has been reported that, when the barbs were exposed on the wound surface, they caused bowel entanglement and subsequent intestinal obstruction. [ 10 12 ] Einarsson et al . reported a technique for suturing the first layer with a barbed suture and the second layer with a nonbarbed suture; the barbs were not exposed on the wound surface which prevented the ileus caused by bowel entanglement.…”

Section: Discussionmentioning

confidence: 99%

A Suturing Method without Exposure of Barbs on the Wound Surface Using a Unidirectional Barbed Monofilament Absorbable Suture (STRATAFIX™) in Laparoscopic Myomectomy

Ota

Takahashi

et al. 2021

Gynecology and Minimally Invasive Therapy

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Objectives: We examined whether a new suturing method that used a single-thread unidirectional barbed suture without exposing the barbs on the wound surface was acceptable compared with the conventional suture method during laparoscopic myomectomy (LM). Materials and Methods: This was a retrospective study. The subjects were 26 women who underwent LM for symptomatic uterine fibroids. The operative time, amount of blood loss, and number of threads used were compared between a group in which suturing was performed with a conventional synthetic absorbable suture (conventional suture group, n = 13) and a group in which suturing was performed using a barbed suture (barbed suture group, n = 13). Results: Operative time in the barbed suture group was significantly shorter than that in the conventional suture group, while blood loss during LM in the barbed suture group was significantly lower than that in the conventional suture group. The number of threads used in the conventional suture group was significantly larger than that in the barbed suture group. No complications were observed in both the groups during LM. Conclusion: This new technique using a barbed suture is safe and feasible for LM.

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“…However, laparoscopic surgery is associated with particular complications, such as SBO induced by metal staples. Several recent reports have described SBO caused by barbed sutures, such as V‐Loc (Covidien, Dublin, Ireland) . Although such new devices are useful, we should pay attention to laparoscopy‐specific complications.…”

Section: Discussionmentioning

confidence: 99%

Atypical clinical presentation of mechanical small bowel obstruction with superior mesenteric vein occlusion caused by a retained free intraperitoneal staple after laparoscopic appendectomy: A case report

Tamura

Nakayama

Kono

et al. 2020

Asian J Endoscop Surgery

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Small bowel obstructions following the use of barbed suture: a review of the literature and analysis of the MAUDE database

Cited by 24 publications

References 27 publications

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

A Suturing Method without Exposure of Barbs on the Wound Surface Using a Unidirectional Barbed Monofilament Absorbable Suture (STRATAFIX™) in Laparoscopic Myomectomy

Atypical clinical presentation of mechanical small bowel obstruction with superior mesenteric vein occlusion caused by a retained free intraperitoneal staple after laparoscopic appendectomy: A case report

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