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Unidirectional barbed suture versus continuous suture with intracorporeal knots in laparoscopic myomectomy: a
Franco Alessandri1, Valentino Remorgida, Pier Luigi Venturini
1Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Genoa, Italy.
Insights
Unidirectional knotless barbed sutures significantly reduce uterine wall closure time and blood loss during laparoscopic myomectomy compared to traditional knot-tying techniques. This method may improve surgical efficiency and patient outcomes.
Area of Science:
- Minimally Invasive Gynecologic Surgery
- Surgical Suturing Techniques
- Reproductive Medicine
Background:
- Laparoscopic myomectomy involves repairing uterine wall defects.
- Traditional continuous sutures with intracorporeal knots can be time-consuming.
- Alternative suturing methods are being explored to improve efficiency.
Purpose of the Study:
- To compare the effectiveness of unidirectional knotless barbed sutures versus continuous sutures with intracorporeal knots.
- To evaluate suture time, operative time, blood loss, and surgical difficulty.
- To assess the utility of barbed sutures in laparoscopic myomectomy.
Main Methods:
- A randomized clinical study (Canadian Task Force Classification I) was conducted.
- 44 women undergoing laparoscopic myomectomy were enrolled.
- Uterine defects were closed using either knotless barbed sutures (group L) or continuous sutures with knots (group V).
Main Results:
- Suture time was significantly lower in the barbed suture group (11.5 min) compared to the traditional group (17.4 min; p <.001).
- Intraoperative blood loss and perceived surgical difficulty were significantly reduced with barbed sutures (p =.004 and p <.001, respectively).
- No significant difference in overall operative time was observed between the groups.
Conclusions:
- Unidirectional knotless barbed sutures facilitate uterine wall defect repair during laparoscopic myomectomy.
- Barbed sutures offer advantages over continuous sutures with knots by reducing closure time and intraoperative blood loss.
- This technique may enhance surgical efficiency in myomectomy procedures.
Study Objective:
To estimate the effectiveness of unidirectional knotless barbed suture and continuous suture with intracorporeal knots in the repair of uterine wall defects during laparoscopic myomectomy.
Design:
Randomized clinical study (Canadian Task Force Classification I).
Setting:
Single-center study in a university hospital.
Patients:
This study enrolled 44 women who underwent laparoscopic myomectomy.
Interventions:
In accord with to the randomization, the uterine wall defects were closed either with a continuous suture with intracorporeal knots (group V) or a unidirectional knotless barbed suture (group L).
Measurements And Main Results:
The time required to suture the uterine wall defect was significantly lower in group L (11.5 ± 4.1 minutes) than in group V (17.4 ± 3.8 minutes; p <.001). However, no significant difference was observed in the operative time between the 2 study groups. The intraoperative blood loss was significantly lower in group L than in group V (p =.004). The degree of surgical difficulty was significantly lower in group L (3.7 ± 1.1) than in group V (6.1 ± 2.1; p <.001).
Conclusion:
The unidirectional knotless barbed suture may facilitate the suture of uterine wall defects during laparoscopic myomectomy. When compared with continuous suture and intracorporeal knots, the barbed suture reduces the time required to suture the uterine wall defect and the intraoperative blood loss.