Self-retaining barbed suture for parenchymal repair during minimally invasive partial nephrectomy

A secure and hemostatic renorrhaphy is the primary challenge of minimally invasive nephron-sparing surgery (MINSS). The laparoscopic surgeon's ability to maintain constant tension on the suture while oversewing the transected parenchyma and collecting system is difficult, even when using robotic technology. A self-retaining barbed suture (SRBS) is a recent innovation that maintains tissue apposition and tension using a novel "self-cinching" mechanism. We describe our technique for SRBS use during MINSS. In our experience, the use of SRBS in this setting is safe and improves suturing efficiency during the time constraint of warm ischemia. We believe that intracorporeal suturing with SRBS during MINSS may help shorten the learning curve associated with this technically challenging step and have adopted it in our standard practice.