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Laparoscopic Tubal Reanastomosis Using Barbed Sutures
P G Paul1, Aditya S Khurd1, Reena Garg1
1Paul's Hospital, Centre for Advanced Endoscopy and Infertility, Kochi, Kerala, India.
Study Objective:
To show a new technique of laparoscopic tubal reanastomosis using barbed sutures.
Design:
Step-by-step explanation of the technique using videos.
Setting:
Laparoscopic tubal reanastomosis is an effective procedure with a high success rate for reversal of tubal sterilization. Conventionally, 4 equidistant interrupted sutures are placed under a magnified view for laparoscopic tubal reanastomosis. This step demands high precision and requires a lot of skill and experience. We have tried to simplify this suturing technique by using barbed sutures because they do not require knotting. Two separate 5-0 Quill barbed sutures (Angiotech Puerto Rico Inc, Aguadilla, Puerto Rico) are used in this technique. The first suture is used for taking 6 and 3 o' clock stitches. The second suture is used for taking 9 and 12 o' clock stitches. With this technique, the purse-string effect on the tubal lumen is reduced.
Interventions:
Laparoscopic tubal reanastomosis using 5-0 Quill barbed sutures (equivalent to United States Pharmacopeia suture size 6-0).
Conclusion:
This technique of laparoscopic tubal reanastomosis using barbed sutures is a feasible and simpler alternative to conventional suturing.
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