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Bidirectional barbed suture in laparoscopic myomectomy: clinical features
Mario Ardovino1, Maria Antonietta Castaldi, Fernando Fraternali
11 Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples , Naples, Italy .
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|December 11, 2013
Summary
Bidirectional knotless barbed sutures significantly reduce uterine wall repair time during laparoscopic myomectomy compared to standard sutures. This method proved safe and effective, with no major complications observed in follow-up.
Area of Science:
- Minimally Invasive Gynecologic Surgery
- Surgical Technology
- Wound Closure Techniques
Background:
- Laparoscopic myomectomy requires effective uterine wall defect repair.
- Standard suture techniques with extracorporeal or intracorporeal knots can be time-consuming.
- Novel closure methods are sought to improve surgical efficiency and safety.
Purpose of the Study:
- To compare bidirectional knotless barbed sutures with standard sutures for uterine wall repair after laparoscopic myomectomy.
- To assess the feasibility, safety, and rapidity of knotless barbed sutures in this context.
Main Methods:
- A randomized clinical trial (Canadian Task Force Classification I) involving 117 women undergoing laparoscopic myomectomy.
- Uterine defects were closed using either standard sutures (extracorporeal or intracorporeal knots) or bidirectional knotless barbed sutures (Quill™).
Main Results:
- Suturing time was significantly reduced with bidirectional knotless barbed sutures compared to standard sutures (P<.001).
- Surgical difficulty was significantly lower when using the knotless barbed suture.
- No significant difference in overall operative time was noted between groups.
Conclusions:
- Bidirectional knotless barbed sutures offer a faster and less difficult method for uterine wall repair during laparoscopic myomectomy.
- The technique demonstrated excellent safety, with no instances of wound dehiscence, bleeding, or major complications at 3-month, 6-month, and 1-year follow-ups.
