Small Bowel Obstruction Resulting from Laparoscopic Vaginal Cuff Closure with a Barbed Suture

Donnellan, Nicole; Mansuria, Suketu

doi:10.1016/j.jmig.2011.03.011

Cited by 82 publications

(53 citation statements)

References 5 publications

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“…On review of the literature, bowel obstruction caused by barbed suture has not previously been described following laparoscopic myomectomy. A case has however been reported following a total laparoscopic hysterectomy where barbed suture used for vaginal cuff closure caused a small bowel obstruction [3]. In our case, it is speculated that the V-loc™ suture unravelled, leaving its barbed surface exposed to the bowel.…”

Section: Discussionmentioning

confidence: 73%

Bowel obstruction due to entanglement with unidirectional barbed suture following laparoscopic myomectomy

2012

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Section: Discussionmentioning

confidence: 73%

Bowel obstruction due to entanglement with unidirectional barbed suture following laparoscopic myomectomy

2012

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“…This complication has been described in three case reports after laparoscopic gynecologic surgery (42)(43)(44). All three case reports described initial laparoscopic pelvic surgery using barbed sutures including promontofixation, sacral colpopexy and vaginal cuff closure.…”

Section: Discussionmentioning

confidence: 93%

Laparoscopic gastrointestinal anastomoses using knotless barbed absorbable sutures are safe and reproducible: a single-center experience with 242 patients

Lee

Kawai

Tashiro

et al. 2016

Jpn. J. Clin. Oncol.

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Objective: Intracorporeal reconstruction of the digestive tract is technically challenging. The V-Loc 180 wound closure device (Covidien) is a self-anchoring unidirectional barbed suture that obviates the need for knot tying. The aim of this prospective cohort study was to investigate the use of the novel suture in gastrointestinal enterotomy closure. Methods: The subjects comprised patients with malignant disease who were scheduled to undergo laparoscopic gastrectomy with curative intent. The barbed suture was used to close the entry hole for the linear stapler during intracorporeal reconstruction following laparoscopic gastric resection. The primary endpoint was the proportion of patients who developed anastomotic leakage at the site where the barbed suture was applied. Results: Between July 2012 and March 2015, 242 patients were enrolled. Of 362 anastomoses, the enterotomy hole at 256 sites was closed using the barbed suture. These 256 sites consisted of 95 gastroduodenostomies, 25 gastrogastrostomies, 13 gastrojejunostomies, 90 jejunojejunostomies, 17 esophagojejunostomies and 16 primary closures of the stomach following local gastric resection. There were no anastomosis-related complications, conversion to usual sutures, mechanical closure of the entry hole and reoperation due to adhesive obstructions or mortality over a median follow-up period of 17.8 months.Conclusions: The use of the unidirectional barbed absorbable suture for gastrointestinal closure is safe and effective in laparoscopic gastrectomy.

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“…Only in three cases small bowel resection was required. To prevent recurrence, the barbed suture may be additionally trimmed and buried either using absorbable sutures, or surgical clips (7).…”

Section: Discussionmentioning

confidence: 99%

Small bowel obstruction due to laparoscopic barbed sutures: An unknown complication?

Segura-Sampedro¹,

Ashrafian²,

Navarro‐Sánchez³

et al. 2015

Rev Esp Enferm Dig

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Background: In recent years there has been an increasing uptake in the use of barbed sutures, particularly in minimally invasive and laparoscopic procedures where they may reduce operating time and improve surgical efficiency. However, little is known about the adverse events associated with these new materials and concerns have arisen regarding their safety in certain procedures.Methods: We performed a search of electronic databases (PubMed, EMBASE, and Cochrane Database). We reveal up to 15 cases of small bowel obstruction (SBO) complicating laparoscopic pelvic surgery that have been reported to date adding two cases of SBO in our own practice following the use of barbed sutures in laparoscopic operations, both requiring surgical re-intervention in the early post-operative period.Results: Fifteen similar cases of small bowel obstruction were identified, all of which occurred in patients undergoing surgery below the transverse colon. Surgical re-intervention was required in all cases although 60% of these were performed laparoscopically.Conclusions: These cases highlight that although barbed sutures provide an attractive means to allow easier and faster laparoscopic suturing, they should be used carefully in inframesocolic surgery and the suture end cut and buried to avoid inadvertent attachment to the small bowel or its mesentery. Barbed suture entanglement should be considered as an uncommon yet potentially serious differential cause for SBO presenting in the early period after laparoscopic surgery where a barbed suture has been used.

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Small Bowel Obstruction Resulting from Laparoscopic Vaginal Cuff Closure with a Barbed Suture

Cited by 82 publications

References 5 publications

Bowel obstruction due to entanglement with unidirectional barbed suture following laparoscopic myomectomy

Bowel obstruction due to entanglement with unidirectional barbed suture following laparoscopic myomectomy

Laparoscopic gastrointestinal anastomoses using knotless barbed absorbable sutures are safe and reproducible: a single-center experience with 242 patients

Small bowel obstruction due to laparoscopic barbed sutures: An unknown complication?

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