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Diabetes
Vol. 20 No 1 | Autumn 2018
Women's Health -> Journal Club
Barbed sutures in laparoscopic hysterectomy
Dr Brett Daniels
FRANZCOG

For most surgeons, the use of barbed sutures to close the vaginal vault at laparoscopic hysterectomy (LH) increases the ease and speed of surgery, compared to interrupted sutures. These three retrospective studies analysed over 1200 cases of laparoscopic hysterectomy, comparing clinical results and complications between vault closure using barbed sutures and conventional non-barbed sutures. None of the trials were randomised. The largest study of 490 participants compared V-Loc™ barbed suture to absorbable Polysorb™, showing a significant reduction in operative time, blood loss and hospital stay for the barbed suture group.1 There was no significant difference in the rates of vault dehiscence. A second study of 334 cases replicated the significant result in reduced operative time with barbed sutures, showing no increased risk of vault dehiscence.2 A third study of 474 cases similarly found a significantly reduced operative time and hospital stay, but no significant difference in vault dehiscence, blood loss or infection.3 In combination, these studies provide confirmation that the use of barbed sutures for vault closure at LH is both convenient and safe.

References

  1. Cong L, Li C, Wei B, Zhan L, Wang W, Xu Y. V-Loc™ 180 suture in total laparoscopic hysterectomy: a retrospective study comparing Polysorb to barbed suture used for vaginal cuff closure. Eur J Obstet Gynecol Reprod Biol. 2016 Dec; 207:18-22. doi: 10.1016/j.ejogrb.2016.09.012.
  2. Kim SM, Baek JM, Song JY, Lee SJ, Park EK, Kim CJ, Lee YS. The use of barbed sutures for vaginal cuff closure during laparoscopic hysterectomy. Arch Gynecol Obstet. 2017 Dec 30. doi: 10.1007/s00404-017-4637-9.
  3. Brown DN, Gobern JM, Unidirectional barbed suture for vaginal-cuff closure in laparoscopic and robotic hysterectomy. J Gynecol Surg. 2016 32(3). DOI: 10.1089/gyn.2015.0082.

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