A Randomised Comparison of Barbed and Non-barbed Absorbable Sutures for Peritoneal Closure in TAPP Hernia Repair

Closure of the peritoneal flap during laparoscopic transabdominal preperitoneal (TAPP) repair is a critical step. Barbed sutures have been proposed to simplify this process, but comparative data with non-barbed sutures are limited. We conducted this study to compare absorbable barbed sutures (polyglyconate) with absorbable non-barbed sutures (polyglactin 910) for peritoneal flap closure in TAPP repair of primary inguinal hernias, focusing on closure time, operative time, postoperative pain, and complications.

This randomised comparative study was conducted at ABVIMS and Dr. RML Hospital, New Delhi, including 60 adult patients with primary unilateral inguinal hernia undergoing TAPP repair. Patients were divided into two groups: Group A (barbed sutures, n = 30) and Group B (non-barbed sutures, n = 30). Primary outcomes included peritoneal closure time and total operative time. Secondary outcomes were postoperative pain (visual analogue scale), ease of surgery, and incidence of seroma or haematoma. Statistical analysis was performed using Statistical Package for the Social Sciences v23, with P < 0.05 considered significant.

Barbed sutures significantly reduced peritoneal closure time (8.61 ± 0.78 min vs. 13.40 ± 0.81 min, P < 0.001) and total operative time (102.5 ± 16.65 min vs. 110.53 ± 11.09 min, P = 0.013). However, postoperative pain was higher in the barbed suture group at 48 h (P = 0.005) and 7 days (P = 0.043). There was no significant difference in seroma or haematoma formation between the groups (P = 0.472).

Absorbable barbed sutures are effective in reducing closure and operative times in TAPP hernia repair but may be associated with higher early postoperative pain. They offer a useful option for improving operative efficiency without increasing complication rates.