Bidirectional barbed suture in laparoscopic myomectomy: clinical features.

Ardovino, Mario; Castaldi, Maria Antonietta; Fraternali, Fernando; Ardovino, Italo; Colacurci, Nicola; Signoriello, Giuseppe; Cobellis, Luigi

OBJECTIVE To compare bidirectional knotless barbed suture versus standard sutures, with either extracorporeal or intracorporeal knots, and to assess the feasibility, safety, and rapidity in repairing a uterine wall defect after laparoscopic myomectomy. SUBJECTS AND METHODS This was a randomized clinical study having a Canadian Task Force Classification of I. In tertiary-care university-based teaching hospitals, 117 women who underwent laparoscopic myomectomy were enrolled. In accord with randomization, uterine wall defects were closed with either extracorporeal (poliglecaprone 25; Monocrylâ„¢-1; Ethicon Inc., Somerville, NJ) or intracorporeal (polyglactin 910; Vicrylâ„¢-1; Ethicon Inc.) knots or a bidirectional knotless barbed suture (Quillâ„¢-0; Angiotech Pharmaceuticals, Inc., Vancouver, BC, Canada). RESULTS Time required to suture was significantly lower in the group operated on with a bidirectional suture than in groups with traditional sutures (P<.001). No significant difference was observed in operative time among the study groups. The degree of surgical difficulty was significantly lower in the Quill group than in the other groups. CONCLUSIONS Use of barbed sutures reduces the time required to repair a uterine wall defect during laparoscopic myomectomy. In a follow-up of patients carried out at 3 months, 6 months, and 1 year after the surgery, there were no wound dehiscence, no bleeding, and no other potential major complications.