Comparison between bidirectional Stratafix® barbed suture and conventional suture in laparoscopic myomectomy: a retrospective study

Abstract

Background Laparoscopic myomectomy (LM) is one of the techniques feasible for the treatment of intramural myoma. This technique is reported to be difficult when large fibroids are involved because of excessive blood loss during surgery. Skillful and fast suturing appears to be associated with reduced blood loss during LM. In this study we compared the surgical outcomes of using bidirectional Stratafix® barbed suture versus conventional suture during LM. Methods This retrospective study included all patients who underwent LM for the treatment of intramural myoma in our institution between 2015 and 2020. The patients were divided into 2 groups according to the technique of suturing during LM: Group 1 comprised patients in whom Stratafix® barbed suture was used ( n = 29), and group 2 comprised those in whom conventional suture was used ( n = 15). Data of patient age, myoma size, the number of myoma nodes, hemoglobin levels, total operation time, total suturing time, and blood loss during surgery were compared between the 2 groups. Results No significant differences in age ( p = 0.463) or myoma size ( P = 0.373) were observed between the 2 groups. Operation time ( P = 0.0104), suturing time ( P = 0.007), and blood loss ( P = 0.0375) during surgery were significantly less with Stratafix® barbed suture than with conventional suture. No patient required intraoperative transfusion or conversion to laparotomy. Conclusion The use of bidirectional barbed suture reduces operation time, suturing time, and blood loss. As these new sutures have barbs, no knot-tying is required; thus, continuous suturing becomes very simple and maintaining hemostasis is easy. Unskilled gynecological surgeons who apply this suture technique can also perform LM easily. As the bidirectional barbed suture has multiple points of fixation, this suture technique can reapproximate tissue securely, which reduces the chances of reoperation because of proper suture knotting. Therefore, bidirectional Stratafix® barbed sutures could be an optimal and efficient alternative to conventional sutures for use by gynecological surgeons in Japan.

Effect of barbed suture versus conventional suture in laparo‐endoscopic single‐site cystectomy for ovarian mature cystic teratoma: An ambispective cohort study

“…Our results show that use of BS in ovarian MCT resection by LESS leads to a significantly shorter time in suturing the ovarian cortex and overall operation time compared with CS, suggesting that BS provides higher operative efficiency. Our findings were consistent with previous studies of conventional laparoscopic myomectomy or vaginal cuff suturing that also found that the use of BS reduces operative time compared with CS 18,19 . In particular, the obvious improvement to suturing and knotting efficiency associated with BS is attributable to bypassing the requirement of knots at the beginning and end of suturing.…”

“…Our findings were consistent with previous studies of conventional laparoscopic myomectomy or vaginal cuff suturing that also found that the use of BS reduces operative time compared with CS. 18,19 In particular, the obvious improvement to suturing and knotting efficiency associated with BS is attributable to bypassing the requirement of knots at the beginning and end of suturing.…”

“…The inclusion criteria were women aged 18 Data for all women meeting the inclusion criteria were collected retrospectively from the internal hospital database, including baseline data, operative video and report, and perioperative outcomes.…”

How to minimize bleeding in laparoscopic myomectomy

“…The use of a bidirectional barbed suture during laparoscopic myomectomy is related to a faster suturing technique. Therefore, the myometrium remains open for less time during the procedure, which may reduce intraoperative bleeding [15 ▪▪ ].…”

“…Another retrospective study [15 ▪▪ ] compared the bidirectional barbed suture (Stratafix, Ethicon Inc., USA) with a conventional suture (Vicryl, Ethicon Inc., USA) during laparoscopic myomectomy with regard to surgical outcomes. This study included 44 patients between April 2015 and June 2020, with 29 patients in the barbed suture group and 15 patients in the conventional suture group.…”