Ex vivo comparison of single‐layer and double‐layer laparoscopic closure of equine bladders with 2 types of barbed sutures

Major, Dustin; Duff, Amy H.; Cohen, Noah D.; Hardy, Joanne

doi:10.1111/vsu.12719

Cited by 9 publications

(16 citation statements)

References 29 publications

(75 reference statements)

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“…Single-layer closure with barbed sutures was chosen because this is a common application of the material. 10,14,16,17,21,22 The V-Loc suture had a mean reduction percentage in lumen diameter of 11%, which is in agreement with previous studies. 2,6,7 In previous work, a luminal percentage reduction after EPF of between 4.7% and 16% has been shown, depending on the location and technique of measurement.…”

Section: Discussionsupporting

confidence: 91%

“…Some construction time may be saved by the use of a double‐layer closure with line reversal, but this has been shown to be no different from a standard double‐layer closure and is not routinely used in the authors’ hospital. Single‐layer closure with barbed sutures was chosen because this is a common application of the material …”

Section: Discussionmentioning

confidence: 99%

“…The first line was extended 5 mm beyond the cut edge before being tied off, cut, and then over‐sewn with a Cushing suture pattern with suture passes placed to cause even inversion of the suture line. The suture line was extended 5 mm beyond the cut edge before the knot was tied. Unidirectional barbed suture (V‐Loc; V‐Loc 90, absorbable wound closure device, Synature, Covidien): The enterotomy was closed in a single continuous Cushing pattern with 2‐0 USP/3 metric 1/2 taper point 30‐mm needle V‐Loc suture with a technique previously described by Major et al To start the suture line, the needle was passed through the seromuscular layer on the upper right side of the incision. The needle was then fed through the tail loop and tightened.…”

Section: Methodsmentioning

confidence: 99%

“…The suture line was extended for an additional 5 mm beyond the enterotomy incision before being reversed by taking two retrograde passes which overlapped the already closed incision. This acted as the knot and prevented suture pull through. Bidirectional barbed (Quill; Quill Monoderm; Surgical Specialities Corporation, Wyomissing, Pennsylvania): The enterotomy was closed in a single continuous Cushing pattern with the 0 USP/3.5 metric Quill with a 1/2 circle 18 diamond point needle equivalent to 2‐0 USP conventional suture as previously described by Major et al To start the suture line, the suture was passed through both sides of the incision at the midpoint, through the seromuscular layer and was pulled until the barbs on the second half of the suture engaged. The suture line was then closed in a Cushing pattern with each pass made 5 mm from the cut edge first from the center to the right and then to the left.…”

Section: Methodsmentioning

confidence: 99%

“…11,13 The proposed benefits of barbed sutures promise an exciting potential for use in equine surgery. Barbed sutures have recently been examined ex vivo in equine bladders, 14 in vitro in equine jejunum, 10 and in vitro in equine linea alba. 15 They have also been evaluated laparoscopically for inguinal ring closure, 16 ablation of the nephrosplenic space, 17 and uteropexy.…”

Section: Introductionmentioning

confidence: 99%

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Ex vivo comparison of barbed sutures for pelvic flexure enterotomy in horses

et al. 2019

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Objective To evaluate two different barbed sutures for closure of pelvic flexure enterotomies and compare results achieved with two previously described closure techniques. Study design Ex vivo. Sample population Twenty‐four fresh cadaver adult equine large colons. Methods Cadavers were randomly assigned to four closure groups (n = 6 each group): single‐layer absorbable suture, double‐layer absorbable suture, single‐layer unidirectional barbed suture, or single‐layer bidirectional barbed suture. Construction time, luminal reduction (percentage), bursting pressure, and method of failure were measured. Cost, leakage, exposed suture, and general appearance were recorded. Comparisons were performed with one‐way analysis of variance and post hoc Bonferroni test (P < .05). Results Double‐layer absorbable closure had the highest bursting pressure (mean = 178.5 mm Hg, SD = 9.79, P < .001) but took more time (P = .001) compared with all other groups. The construction time of both barbed suture closures did not differ from the single‐layer closure (P > .06). Bursting strengths of both unidirectional (mean = 91.6 mm Hg, SD = 5.57) and bidirectional (mean = 87.5 mm Hg, SD = 8.69) barbed sutures were lower (P > .006 for both) than those of both single‐ (mean = 117.6 mm Hg, SD = 11.69) and double‐layer (mean = 178.5 mm Hg, SD = 9.79) closures. Unidirectional barbed suture closure had a reduction in lumen diameter (P = .004) compared with bidirectional and single‐layer closures. Conclusion Enterotomy closures with the two different barbed suture patterns were comparable in bursting strength and construction time. However, the barbed suture patterns had lower bursting strength compared with traditional single‐ and double‐layer closures. Unidirectional barbed suture closure also reduced lumen diameter. Clinical significance Closure of a large colon enterotomy with barbed suture patterns may be less secure than single‐ and double‐layer suture closure.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ex vivo comparison of barbed sutures for pelvic flexure enterotomy in horses

et al. 2019

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Bladder

Schott¹,

Woodie²

2019

Equine Surgery

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Minimally invasive repair of congenital inguinal hernias in nine foals using an automated laparoscopic suturing device and barbed suture

Maurer,

McEntee,

O'Brien

et al. 2023

Equine Veterinary Education

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SummaryBackgroundLaparoscopic herniorrhaphy using staples or smooth suture has been shown to be safe and effective for the surgical treatment of congenital inguinal hernia in colts and gives the possibility to spare the testicles. An automated laparoscopic suturing device combined with barbed suture reduces the technical challenges of laparoscopic suturing.ObjectivesThe objective of the study was to describe the application of the Endo Stitch™ automated suturing device in combination with V‐Loc™ unidirectional barbed suture for laparoscopic herniorrhaphy in foals with congenital inguinal hernia, share experiences and provide long‐term follow‐up regarding the outcome.Study designRetrospective case series.MethodsMedical records of all foals that had laparoscopic herniorrhaphy using the Endo Stitch™ combined with V‐Loc™ unidirectional barbed suture at two equine referral hospitals between May 2015 and July 2022 were reviewed. Long‐term follow‐up was conducted by telephone interviews with the owners using a standardised questionnaire.ResultsNine foals aged 0.5–13 weeks suffering from unilateral (seven cases) or bilateral (two cases) indirect inguinal hernia underwent unilateral (two cases) or bilateral (seven cases) laparoscopic herniorrhaphy using the described technique. In two animals, the testicles were spared, five animals were bilaterally castrated, and two were unilaterally castrated at the time of herniorrhaphy. No major intraoperative complications occurred. Postoperatively, foals were bright and alert and none of them had significant complications attributable to the surgery. Median long‐term follow‐up was 8 months. No re‐herniation was observed in any of the cases at any time postoperatively.Main limitationsRetrospective study design and follow‐up period of less than 6 months in three cases.ConclusionsLaparoscopic herniorrhaphy using the Endo Stitch™ laparoscopic suturing device and V‐Loc™ barbed suture is technically less demanding than previously described laparoscopic techniques and effective in preventing re‐herniation in foals suffering from congenital inguinal hernia. A fast and uncomplicated postoperative recovery can be expected.

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Ex vivo comparison of single‐layer and double‐layer laparoscopic closure of equine bladders with 2 types of barbed sutures

Abstract: In this ex vivo study, both closure techniques and both suture types appeared to be acceptable for laparoscopic closure of the urinary bladder in adult horses.

Cited by 9 publications

References 29 publications

Ex vivo comparison of barbed sutures for pelvic flexure enterotomy in horses

Ex vivo comparison of barbed sutures for pelvic flexure enterotomy in horses

Bladder

Minimally invasive repair of congenital inguinal hernias in nine foals using an automated laparoscopic suturing device and barbed suture

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