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Enterotomy closure using knotless and barbed suture in laparoscopic upper gastrointestinal surgeries
Therese Bautista1, Asim Shabbir2,3, Jaideepraj Rao4
1Upper Gastrointestinal Surgery Division, Department of Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Surgical Endoscopy
|July 16, 2015
Summary
Barbed sutures simplify intracorporeal enterotomy closure in laparoscopic surgeries. This study found them safe and effective for upper gastrointestinal procedures when used with proper technique, reducing suturing time.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Gastrointestinal Surgery
Background:
- Barbed sutures are increasingly used for intracorporeal suturing in laparoscopic digestive surgeries.
- This study focuses on their application in closing enterotomies during upper gastrointestinal and bariatric procedures.
Purpose of the Study:
- To present initial experiences with barbed sutures for enterotomy closure in laparoscopic upper gastrointestinal and bariatric surgeries.
- To share an optimal technique for utilizing barbed sutures in this context.
Main Methods:
- A retrospective review of 50 patients undergoing laparoscopic enterotomy closure with barbed sutures across two institutions.
- Data collected included patient demographics, anastomotic time, diet onset, hospital stay, and early post-operative complications.
Main Results:
- Barbed sutures significantly reduced mean suturing time for Roux-en-Y gastrojejunal (17.34 min) and jejunojejunal (19.46 min) closures compared to standard sutures.
- Mean diet onset was 2 days, mean hospital stay was 7 days, with one anastomotic leak (1.6%) attributed to technical error.
- Optimal technique involves pushing tissues for better apposition, preventing tearing.
Conclusions:
- Barbed closure sutures are safe and effective for laparoscopic upper gastrointestinal procedures when appropriate technique is employed.
- They offer a simplified method for intracorporeal enterotomy closure.
