Use of Bidirectional Barbed Suture in Laparoscopic Myomectomy: Evaluation of Perioperative Outcomes, Safety, and Efficacy

Einarsson, Jon I.; Chavan, Niraj R.; Suzuki, Yoko; Jónsdóttir, Guðrún; Vellinga, Thomas T.; Greenberg, James A

doi:10.1016/j.jmig.2010.10.003

Cited by 70 publications

(57 citation statements)

References 6 publications

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“…A retrospective randomized trial by Einarsson et al [20] confirmed that the use of bidirectional barbed suture can reduce suturing time and decrease the length of hospitalization. Conversely, there was no significant difference in the Hb drop and in the incidence of postoperative complications.…”

Section: Resultsmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

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Background: This work analyzes the feasibility and effectiveness of barbed suture during laparoscopic myomectomy. Methods: Eight works have been carefully examined for the meta-analysis from all papers published online until November 2017. Results: Barbed suture proved to be superior to traditional suture technique in blood loss in laparoscopic myomectomy (Standardized Mean Difference [SMD] –0.650, 95% CI –1.420 to –0.119, p = 0.098, test for heterogenity p < 0.0001, I² = 95.54%), Hb drop (SMD –1.452, 95% CI –3.590 to 0.687, p = 0.183, test for heterogenity p < 0.0001, I² = 99.08%), suturing difficulty (SMD –0.638, 95% CI –0.935 to –0.342, p ≤ 0.001, test for heterogenity p = 0.25, I² = 27.84%), suturing time (SMD –1.197, 95% CI –1.848 to –0.549, p ≤0.001, test for heterogenity p = 0.0001, I² = 83.30%) and total operative time (SMD –0.687, 95% CI –0.804 to –0.569, p ≤ 0.001, test for heterogenity p = 0.292, I² = 17.44%). Barbed suture demonstrated to be better in comparison with the control group even with regard to the length of hospitalization (SMD –0.278, 95% CI –0.543 to 0.012, p = 0.040, test for heterogenity p = 0.025, I² = 61.85%), and to perioperative complications (SMD 0.708, 95% CI 0.503–0.996, p = 0.048, test for heterogenity p = 0.79, I² = 0%). Conclusion: Barbed suture significantly facilitates laparoscopic myomectomy by reducing the total operative/suturing time, estimated blood loss/Hb drop, and reduction of perioperative complications.

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Section: Resultsmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

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“…Recently, an absorbable unidirectional barbed suture has become available (V-Loc™180, Covidien, Mansfield, MA) ( Figure-1). This suture has been used for skin and soft tissue closures, gynecologic procedures, and bowel anastomosis in a porcine model (6)(7)(8). Anastomoses using standard monofilament for running closure requires frequent re-tightening, with some surgeons relying on the assistant to follow the suture to maintain tension.…”

mentioning

confidence: 99%

Unidirectional barbed suture versus standard monofilament for urethrovesical anastomosis during robotic assisted laparoscopic radical prostatectomy

et al. 2012

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INTRODuCTIONRobotic-assisted laparoscopic prostatectomy (RALP) is a widely utilized, minimally invasive option for the treatment of prostate cancer and, in the short term, has demonstrated similar oncologic outcomes when compared with the open radical prostatectomy (1,2). The urethrovesical anastomosis (UVA) is a technically challenging aspect of RALP (3). Several UVA techniques have been described including a running suture anastomosis, interrupted suPurpose: V-Loc™180 (Covidien Healthcare, Mansfield, MA) is a new unidirectional barbed suture that may reduce loss of tension during a running closure. We evaluated the use of the barbed suture for urethrovesical anastomosis (UVA) during robotic assisted laparoscopic prostatectomy (RALP). Time to completion of UVA, post-operative anastomotic leak rate, and urinary incontinence were compared in patients undergoing UVA with 3-0 unidirectional-barbed suture vs. 3-0 Monocryl™ (Ethicon, Somerville, nJ). Materials and Methods: Data were prospectively collected for 70 consecutive patients undergoing RALP for prostate cancer between november 2009 and October 2010. In the first 35 patients, the UVA was performed using a modified running van Velthoven anastomosis technique using two separate 3-0 monofilament sutures. In the subsequent 35 patients, the UVA was performed using two running novel unidirectional barbed sutures. At 7-12 days postoperatively, all patients were evaluated with a cystogram to determine anastomotic integrity. Urinary incontinence was assessed at two months and five months by total daily pad usage. Clinical symptoms suggestive of bladder neck contracture were elicited. Results: Age, PSA, Gleason score, prostate size, estimated blood loss, body mass index, and clinical and pathologic stage between the 2 groups were similar. Comparing the monofilament group and V-Loc™180 cohorts, average time to complete the anastomosis was similar (27.4 vs. 26.4 minutes, p = 0.73) as was the rate of urinary extravasation on cystogram (5.7 % vs. 8.6%, p = 0.65). There were no symptomatic bladder neck contractures noted at 5 months of follow-up. At 2 months, the percentage of patients using 2 or more pads per day was lower in the V-Loc™180 cohort (24% vs. 44%, p < 0.02). At 5 months, this difference was no longer evident. Conclusions: Time to complete the UVA was similar in the intervention and control groups. Rates of urine leak were also comparable. While the V-Loc™180 was associated with improved early continence, this difference was transient.

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“…In general, LM is associated with a shorter hospital stay, faster recovery and less blood loss that could be explained in part by the tamponade effect of the pnuemoperitoneum. Patient satisfaction with operative scar after LM is good (24) and as well as fertility satisfaction and reproductive outcome (23).…”

Section: Reconstructive Laparoscopic Myomectomy (Lm)mentioning

confidence: 99%

“…Suturing is usually done along one or two layers including the serosa depending on the depth of incision with interrupted, simple or more frequently cross-stitches tied intracorporeally using 1 or 0 Polyglactin sutures or any delayed absorbable sutures (figure 3). A recent study (35) evaluated the use of bidirectional barbed suture and found it significantly shortens the mean duration of surgery. Morcellation of the myoma is followed by irrigation and placement of adhesion barrier.…”

Section: Operative Techniquementioning

confidence: 99%

Reconstructive Endoscopic Myomectomy

Darwish¹

2011

Advanced Gynecologic Endoscopy

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Use of Bidirectional Barbed Suture in Laparoscopic Myomectomy: Evaluation of Perioperative Outcomes, Safety, and Efficacy

Cited by 70 publications

References 6 publications

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Unidirectional barbed suture versus standard monofilament for urethrovesical anastomosis during robotic assisted laparoscopic radical prostatectomy

Reconstructive Endoscopic Myomectomy

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