The Use of Barbed Suture for Vaginal Cuff Closure in Total Laparoscopic Hysterectomy

Roda JL, Herraiz

doi:10.15406/ogij.2015.03.00088

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…The latter study also found a longer time to dehiscence in barbed sutures, compared to polyglactin sutures (73 days vs. 29 days, respectively). Though a study [ 35 ] assured the safety of the use of barbed sutures, two case-reports of small bowel volvulus and obstruction resulting from barbed sutures were published [ 51 , 52 ]. Animal studies showed conflicting results, with one study in ewes showing no difference in adhesion formation between barbed and polyglactin sutures [ 53 ], while a similar experiment in rats found more adhesion formation and increased presence of inflammatory cells with barbed sutures [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…Barbed sutures were also associated with shorter operative time [ 31 , 32 ], less post-operative bleeding [ 14 ], shorter hospital stay [ 33 ] and less vaginal cuff granulation at 6 months post-operatively [ 34 ]. The use of unidirectional barbed suture for vaginal cuff closure was found to be safe, with no major complications reported (in a cohort of 121 patients) [ 35 ]. Fuchs Weizman et al [ 16 ] found a continuous suture to be protective against VCD, but found no difference in comparing braided and barbed thread, nor hand or laparoscopic sewn.…”

Section: Review Of the Literaturementioning

confidence: 99%

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Vaginal Cuff Dehiscence: Two Case Reports and a Review of the Literature

Jaime Moens,

Buonomo,

De Sutter

2023

JCM

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Vaginal cuff dehiscence (VCD) is a rare but serious condition associated with high morbidity, especially in the presence of an evisceration. It usually occurs as a complication of hysterectomy, but has also been reported after other pelvic surgeries. In this article, we will present two cases of vaginal cuff dehiscence with evisceration in post-menopausal patients. Both cases occurred post-operatively, the first after a laparoscopic radical hysterectomy and the other after a trachelectomy performed by robotic-assisted laparoscopy (with a prior history of subtotal hysterectomy). Both cases were treated surgically, the first by a combined laparoscopic and vaginal approach, and the second case only by laparoscopic approach. The main risk and protective factors are discussed in a narrative literature review which summarizes the available evidence on this rare condition, discussed by type of study designs and thus evidence level. A laparoscopic vaginal cuff closure is the most protective factor in preventing VCD, compared to a vaginal closure. Clinicians should be aware of this condition and of its risk factors and precipitating events in order to identify high-risk patients. Knowledge of these allows prompt recognition, which is crucial for adequate management, for which multiple approaches have been described.

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Section: Discussionmentioning

confidence: 99%

Section: Review Of the Literaturementioning

confidence: 99%

Vaginal Cuff Dehiscence: Two Case Reports and a Review of the Literature

Jaime Moens,

Buonomo,

De Sutter

2023

JCM

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Prospective Interventional Study to Quantify Barbed Suture Exposure at Vaginal Vault and Assess Post-Operative Risk

Shukla¹,

Shukla²,

Shah³

et al. 2020

OJOG

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Unidirectional Barbed Suture Versus Polyglactin 910 Suture for Vaginal Cuff Closure in Total Laparoscopic Hysterectomy

Khoiwal¹,

Kapoor²,

Gaurav³

et al. 2021

Cureus

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Introduction and objective Laparoscopic suturing of the vaginal cuff and knotting is the most challenging step in total laparoscopic hysterectomy (TLH) and requires surgical skill. The objective of this study was to compare the efficacy and safety of unidirectional barbed suture (V-Loc TM 180; Covidien, Mansfield, MA) with the conventional polyglactin 910 suture (coated Vicryl; Covidien) for vaginal cuff closure in patients with benign uterine diseases undergoing total laparoscopic hysterectomy. Methods A prospective observational study was carried out at the department of obstetrics and gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, for two years. A total of 109 patients with benign uterine diseases planned for TLH were included in the study. Laparoscopic vaginal cuff closure was performed with the unidirectional barbed suture (V-Loc) in 44 patients and with the standard polyglactin 910 suture (Vicryl) in 65 patients. The primary outcome measure was vaginal cuff closure time. Secondary outcome measures included total operative time, blood loss, average number of stitches, postoperative pain perception, duration of hospital stay, vaginal cuff-related complications, and dyspareunia. Results Demographic variables and baseline characteristics were similar in both groups except for body mass index (BMI). The mean vaginal cuff closure time was significantly less in the V-Loc group (8.84 ± 2.18 min) than in the Vicryl group (11.66 ± 1.74 min) (p = <0.01). Mean operative time was comparable in both groups (V-Loc group - 109.36±33.02 and Vicryl group - 108.49±40.48; p = 0.91). Other intraoperative parameters, such as blood loss and number of stitches in cuff closure, and postoperative characteristics, such as pain score, duration of hospital stay, vaginal cuff-related complications (vault cuff dehiscence, hematoma, or abscess), and dyspareunia, were comparable in both the groups. Conclusions The unidirectional barbed suture significantly reduces vaginal cuff closure time. It is a safe, effective, and well-tolerated alternative to conventional Vicryl suture for vaginal cuff closure in TLH without increasing the risk of postoperative vaginal complications particularly where affordability is not an issue and resources are accessible.

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The Use of Barbed Suture for Vaginal Cuff Closure in Total Laparoscopic Hysterectomy

Cited by 3 publications

References 22 publications

Vaginal Cuff Dehiscence: Two Case Reports and a Review of the Literature

Vaginal Cuff Dehiscence: Two Case Reports and a Review of the Literature

Prospective Interventional Study to Quantify Barbed Suture Exposure at Vaginal Vault and Assess Post-Operative Risk

Unidirectional Barbed Suture Versus Polyglactin 910 Suture for Vaginal Cuff Closure in Total Laparoscopic Hysterectomy

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