Barbed Versus Standard Suture: A Randomized Trial for Laparoscopic Vaginal Cuff Closure

Einarsson, Jon I.; Cohen, Sarah L.; Gobern, Joseph M.; Sandberg, Evelien M.; Hill-Lydecker, C.I.; Wang, Karen; Brown, Douglas

doi:10.1016/j.jmig.2013.02.015

Cited by 47 publications

(40 citation statements)

References 14 publications

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“…4,10,12,14,15,18 However, after our statistical analysis, it was shown that there is no statistically significant difference in vaginal cuff dehiscence between the 2 groups. The morphology of tissue collagen structure, the distribution of blood supply, and the possibility of infection should be taken into account as possible reasons.…”

Section: Discussionmentioning

confidence: 73%

“…Because of the type and the quality of the included studies, the Jadad score was applied only in 3 studies. [8][9][10] …”

Section: Quality Assessment Of the Included Studiesmentioning

confidence: 99%

“…Four studies were included in the analysis regarding the time needed for the conclusion of the operation, either concerning hysterectomy [9][10][11]18 or regarding myomectomy. 8,13,17,19 In studies referring to hysterectomy the use of barbed suture did not show any significant superiority in the operative time over conventional suture.…”

Section: Duration Of Operationmentioning

confidence: 99%

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The Role of Knotless Barbed Suture in Gynecologic Surgery

2014

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Knotless barbed sutures are an innovative suturing material that can facilitate laparoendoscopic operations. The purpose of this study is to examine the available evidence on the application of barbed sutures on both laparoscopic and robotic operations in the field of gynecologic surgery. A systematic search was performed in PubMed, Scopus, and Cochrane databases. In total, 1991 patients were included in the study. The duration of closure with knotless suture ranged from 3.9 to 13 minutes, which was less than the use of conventional suture in every study. The duration of suturing was significantly less in the barbed suture group during hysterectomy, the mean difference between the observed groups was 2.41 minutes per operation (95% confidence interval, 1.23-3.59) whereas in myomectomy there was no statistically significant difference between compared groups. Concerning the estimated blood loss and the presence of major bleeding in hysterectomy, no statistical difference between the 2 groups was observed, while the estimated blood loss in myomectomy was found to be statistically significant (P = .04). Regarding the dehiscence of vaginal cuff in hysterectomy, no statistically significant difference was observed (1031 patients, odds ratio = 1.63; 95% confidence interval = 0.37-7.25). The complete absence of knots, the even distribution of tissue strength along the wound, and the reduction of operation time are the main advantages of this type of sutures. Additional clinical trials of higher methodological quality are necessary to further clarify suturing advantages and postoperative outcomes of the barbed sutures.

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Section: Discussionmentioning

confidence: 73%

“…Because of the type and the quality of the included studies, the Jadad score was applied only in 3 studies. [8][9][10] …”

Section: Quality Assessment Of the Included Studiesmentioning

confidence: 99%

Section: Duration Of Operationmentioning

confidence: 99%

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The Role of Knotless Barbed Suture in Gynecologic Surgery

2014

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“…In all except 1 study, significant reductions of time required for suturing were observed in the barbed group. Einarsson et al [11] used LapraTy (Ethicon, Inc., Somerville, NJ) clips instead of laparoscopic knot tying in both groups, which might serve to minimize or eliminate differences between groups. Only Bogliolo et al [10] demonstrated a significant difference in total operation times between groups.…”

Section: Discussionmentioning

confidence: 99%

Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure

et al. 2016

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We compared results using unidirectional barbed sutures and conventional sutures for vaginal cuff closure during total laparoscopic hysterectomy (TLH).The electronic medical records and surgical videos of 170 patients who underwent TLH between January 2013 and March 2015 at Uijeong-bu St. Mary's Hospital of Catholic University of Korea were reviewed. Vaginal cuffs were closed using the 2-layer continuous running technique with unidirectional barbed sutures (V-Loc; Covidien, Mansfield, MA) in 64 patients and with polycolic acid Vicryl; Ethicon, Somerville, NJ sutures in 106 patients. Procedure time, clinical characteristics, and postoperative complications were compared between the 2 study groups. There were no differences in clinical characteristics (age, body mass index, and demographic data) between groups. The mean suturing time was significantly reduced in the barbed group (7.2 vs 12.2 minutes; P < 0.001), although the mean number of stitches was greater than in the Vicryl group (14.1 vs 12.3, P < 0.001). Perioperative complications, including episodes of vaginal bleeding, vaginal cuff cellulitis, and postoperative fever, did not differ between groups. There were no instances of vaginal cuff dehiscence in either group. Unidirectional barbed sutures can be used safely to reduce procedure time and surgical difficulty relative to conventional sutures in laparoscopic vaginal cuff closure.

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“…In another study of barbed suture, the incidence of postoperative dehiscence was substantially reduced [17]. When residents and fellows performed the closure, barbed suture did not necessarily shorten the operation time relative to that taken by an experienced doctor using conventional suturing, although the suture time itself was significantly short [18]. Although Bogliolo et al [19] reported significant shortening of the operation time with barbed suture, the incidence of postoperative complications, such as dehiscence and bleeding, did not differ significantly.…”

Section: Discussionmentioning

confidence: 99%

Long unidirectional barbed suturing technique with extracorporeal traction in laparoscopic myomectomy

et al. 2014

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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.

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Barbed Versus Standard Suture: A Randomized Trial for Laparoscopic Vaginal Cuff Closure

Cited by 47 publications

References 14 publications

The Role of Knotless Barbed Suture in Gynecologic Surgery

The Role of Knotless Barbed Suture in Gynecologic Surgery

Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure

Long unidirectional barbed suturing technique with extracorporeal traction in laparoscopic myomectomy

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