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Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure
Jin Hwi Kim1, Seung Won Byun, Jae Yeon Song
1aDepartment of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital bDepartment of Obstetrics and Gynecology, Seoul St. Mary's Hospital cDepartment of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Unidirectional barbed sutures significantly reduce suturing time for vaginal cuff closure during total laparoscopic hysterectomy (TLH). This method offers a safe alternative to conventional sutures, simplifying the procedure without increasing complications.
Area of Science:
- Minimally Invasive Gynecologic Surgery
- Surgical Technology
- Suturing Techniques
Background:
- Vaginal cuff closure is a critical step in total laparoscopic hysterectomy (TLH).
- Conventional sutures may prolong operative time and increase surgical difficulty.
- Advancements in suture technology aim to improve efficiency and safety in gynecologic procedures.
Purpose of the Study:
- To compare the efficacy and safety of unidirectional barbed sutures versus conventional sutures for vaginal cuff closure during TLH.
- To evaluate the impact of barbed sutures on procedure time, surgical difficulty, and postoperative complications.
- To assess the feasibility of using barbed sutures in laparoscopic vaginal cuff closure.
Main Methods:
- A retrospective review of 170 patients undergoing TLH between January 2013 and March 2015.
- Vaginal cuff closure was performed using either unidirectional barbed sutures (V-Loc) in 64 patients or conventional polycolic acid Vicryl sutures in 106 patients.
- Comparison of suturing time, number of stitches, and postoperative complications including bleeding, cellulitis, fever, and dehiscence.
Main Results:
- Mean suturing time was significantly reduced with barbed sutures (7.2 minutes) compared to conventional sutures (12.2 minutes; P < 0.001).
- The mean number of stitches was greater in the barbed group (14.1) than the conventional group (12.3; P < 0.001).
- No significant differences were observed in clinical characteristics or perioperative complications (bleeding, cellulitis, fever) between the groups. No vaginal cuff dehiscence occurred in either group.
Conclusions:
- Unidirectional barbed sutures provide a safe and effective alternative for vaginal cuff closure during TLH.
- Barbed sutures significantly reduce procedure time and surgical difficulty compared to conventional sutures.
- The use of barbed sutures does not appear to increase the risk of postoperative complications or dehiscence.
