How Reliable Is Intracorporeal Laparoscopic Knot Tying?

López, Pedro-José; Veness, John; Wojcik, Andrew; Curry, Joe

doi:10.1089/lap.2006.16.428

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…Knowing that running suture reduce the warm ischemia time indifferent of tumor size and location [6], and laparoscopic knot tying is time consuming and often are weaker than those tied by hand in open surgery [7][8][9], we recommend for laparoscopic nephron sparing surgery by retroperitoneal approach (which provides little space for maneuver) a knotless running suture for rennorhaphy, with end-tails Hem-o-lock TM clips to secure the suture. Table 2 MEDIUM RISK ZONAL NePhRO SCORE (7)(8)(9) Both suture materials used for renorrhaphy present good outcomes in terms of biodegradability [7,10], the suture requiring a good tensile strength for over a month in order to maintain good hemostasis and facilitate renal healing. Another important issue is bacterial adhesion witch seems to favor polydioxanone use over polyglicolic acid [11].…”

Section: Resultsmentioning

confidence: 99%

Comparative Study Between Polydioxanone Unidirectional Barbed Suture and Absorbable Polyglactin Running Suture in Partial Nephrectomy

Pirvut¹,

Grigore²,

Mihai³

et al. 2018

Mat.Plast.

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Combining technological development in the laparoscopic field alongside the increase of surgeon�s experience in partial nephrectomy, have extended the indications of laparoscopic nephron sparing surgery to more complicated cases, increasing the role of suture materials in obtaining a good collecting system closure and hemostasis, with short warm ischemia time and low postoperative complications rate. Suturing materials are continuously developed combining new and unique designs with novel synthetic materials in order to fulfill surgeon�s exigence.

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Section: Resultsmentioning

confidence: 99%

Comparative Study Between Polydioxanone Unidirectional Barbed Suture and Absorbable Polyglactin Running Suture in Partial Nephrectomy

Pirvut¹,

Grigore²,

Mihai³

et al. 2018

Mat.Plast.

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show abstract

“…The laparoscopic suture represents an element of difficulty and requires a prolonged practice in order to obtain a high level of ability. Although a good skill in laparoscopic suture can be obtained through practice and perseverance, the laparoscopic knots are, generally speaking, less effective compared to those performed on conventional surgery [8][9]. The most common gynecologic procedures using barbed suture are laparoscopic myomectomy, total hysterectomy and sacrocolpopexy.…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Barbed Suture in Gynaecology. A Review of the Literature

2017

Med. Con.

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In recent years, a new class of material suture -barbed suture-has been introduced into the surgery practice. The main advantage of barbed suture is the needless of making surgical knots, consecutively reducing the operating time and blood loss during laparoscopic procedures.We searched the English databases (Pubmed, Medline) for medical literature studying the application of barbed suture in gynecology.The main gynecologic procedures in which barbed suture gain place are laparoscopic procedures like: myomectomy, hysterectomy and sacrocolpopexy. This review focuses on barbed suture for a better understanding of the opportunity of using this new material in gynecologic practice.Based on literature data and our experience, we conclude that a further development is needed and the incorporation of this suture material into the clinical practice should be actively explored.

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Risk identification and technical modifications reduce the incidence of post-cholecystectomy bile leakage: analysis of 5675 laparoscopic cholecystectomies

Nassar

2021

Langenbecks Arch Surg

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Purpose The main sources of post-cholecystectomy bile leakage (PCBL) not involving major duct injuries are the cystic duct and subvesical/hepatocystic ducts. Of the many studies on the diagnosis and management of PCBL, few addressed measures to avoid this serious complication. The aim of this study was to examine the causes and mechanisms leading to PCBL and to evaluate the effects of specific preventative strategies. Methods A prospectively maintained database of 5675 consecutive laparoscopic cholecystectomies was analysed. Risk factors for post-cholecystectomy bile leakage were identified and documented and technical modifications and strategies were adopted to prevent this complication. The incidence, causes and management of patients who suffered bile leaks were studied and their preoperative characteristics, operative data and postoperative outcomes were compared with patients where potential risks were identified and PCBL avoided and with the rest of the series. Results Twenty-five patients (0.4%) had PCBL (7 expected and less than half requiring reintervention): 11 from cystic ducts (0.2%), 3 from subvesical ducts (0.05%) and 11 from unconfirmed sources (0.2%). The incidence of cystic duct leakage was significantly lower with ties (0.15%) than with clips (0.7%). Fifty-two percent had difficulty grades IV or V, 36% had empyema or acute cholecystitis and 16% had contracted gallbladders. Twelve patients required 17 reinterventions before PCBL resolved; 7 percutaneous drainage, 6 ERCP and 4 relaparoscopy. The median hospital stay was 17 days with no mortality. Hepatocystic ducts were encountered in 72 patients (1.3%) and were secured with loops (54.2%), ties (25%) or sutures (20.8%) with no PCBL. Eighteen sectoral ducts were identified and secured. Conclusion Ligation of the cystic duct reduces the incidence of PCBL resulting from dislodged endoclips. Careful blunt dissection in the proper anatomical planes avoiding direct or thermal injury to subvesical and sectoral ducts and a policy of actively searching for hepatocystic ducts during gallbladder separation to identify and secure them can reduce bile leakage from such ducts.

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How Reliable Is Intracorporeal Laparoscopic Knot Tying?

Cited by 7 publications

References 16 publications

Comparative Study Between Polydioxanone Unidirectional Barbed Suture and Absorbable Polyglactin Running Suture in Partial Nephrectomy

Comparative Study Between Polydioxanone Unidirectional Barbed Suture and Absorbable Polyglactin Running Suture in Partial Nephrectomy

Clinical Application of Barbed Suture in Gynaecology. A Review of the Literature

Risk identification and technical modifications reduce the incidence of post-cholecystectomy bile leakage: analysis of 5675 laparoscopic cholecystectomies

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