Postoperative small intestinal obstruction caused by barbed suture after robot-assisted laparoscopic sacrocolpopexy

We present a case of small intestinal obstruction due to a barbed suture used for peritoneal closure during robot-assisted laparoscopic sacrocolpopexy.

A female patient with pelvic organ prolapse underwent robot-assisted laparoscopic sacrocolpopexy uneventfully. Intestinal obstruction developed on postoperative Day 4. Conservative treatment with the ileus tube failed to improve abdominal symptoms. The laparoscopic examination on postoperative Day 14 revealed the barbed suture entangled with the small intestinal mesentery. The tail of the barbed suture was laparoscopically detached from the mesentery without damaging the small intestine. The tail of the barbed suture was trimmed; an antiadhesive material was applied to the peritoneal closure line and the trimmed tail of the barbed suture.

We recommend the use of conventional absorbable sutures in the peritoneal cavity because of the potential risk of intestinal obstruction caused by the barbed suture.