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A simple and effective technique for laparoscopic gastrorrhaphy: modified Graham's patch with barbed suture
Ta-Chun Chou1, Chun-Hui Lee1, Ruey-Shyang Soong2,3
1Department of Surgery, Keelung Branch, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist, 204201, Keelung City, Taiwan.
BMC Surgery
|September 27, 2023
Summary
A new laparoscopic technique using barbed sutures for perforated peptic ulcers significantly reduces surgical time. This method offers a safe and effective approach for managing acute abdomen with minimally invasive surgery.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Peptic ulcers result from acid imbalance; proton pump inhibitors (PPIs) are effective treatments.
- Perforated peptic ulcer (PPU) remains a significant cause of mortality without timely intervention.
- Laparoscopic repair is a feasible and safe approach for PPU management.
Purpose of the Study:
- To evaluate a novel laparoscopic technique combining barbed sutures with a modified Graham's patch for PPU repair.
- To compare the efficacy and safety of this new technique against traditional laparoscopic primary repair.
Main Methods:
- Retrospective analysis of 154 patients undergoing laparoscopic repair for PPU from January 2014 to December 2020.
- Patients were divided into two groups: V-loc barbed suture group (V group, n=59) and traditional laparoscopic primary repair group (P group, n=95).
Main Results:
- The V-loc group demonstrated a significantly shorter operative time (96.93 ± 22.14 min) compared to the P group (123.97 ± 42.14 min; P < 0.001).
- Morbidity rates (Clavien-Dindo classification > 4) and post-operative leakage rates were comparable between the two groups (5 vs. 5, and 2 vs. 1, respectively; P = 0.432).
Conclusions:
- Laparoscopic repair utilizing barbed sutures and a modified Graham's patch is a simple, effective, and safe technique for managing acute abdomen due to PPU.
- This innovative approach can be readily adopted by experienced surgeons and surgical trainees in minimally invasive surgery.
