Absorbable Barbed Suture Research Articles

The Overlapping Running Suture Method Using Single Knotless Barbed Absorbable Suture Material for Abdominal Wall Closure after Single Incision Laparoscopic Appendectomy: Comparison with the Traditional Interrupted Closure Technique

The aim of our study was to present an abdominal wall closure technique using barbed suture V-Loc™ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA.

Absorbable barbed suture device for laparoscopic peritoneal closure after hernia repair via the transabdominal preperitoneal approach: A single-center experience with 257 cases.

The laparoscopic transabdominal preperitoneal approach requires peritoneal closure and technically skilled knotting. We have started to use a barbed running suturing device (V-Loc 180) without knotting for transabdominal preperitoneal repair of hernias. This study aimed to determine whether using V-Loc 180 was safe and shortened the time for laparoscopic peritoneal closure. Between December 2010 and February 2017, 3-0 V-Loc 180 and a multifilament absorbable running suture (3-0 Vicryl) were used for three-port transabdominal preperitoneal repair of inguinal hernia in 363 cases. Data including peritoneal closure time and the complications were retrospectively recorded. Factors identified as significantly prolonging the peritoneal closure time were the hernia side (P = 0.0269), the type of hernia (P = 0.001), the suture device used (P < 0.0001), and the surgeon's experience (P < 0.0001). Use of the barbed suture was associated with a significantly shorter peritoneal closure time than the multifilament suture (mean closure time: 10.2 and 12.7 min, respectively). While there were no postoperative complications in the barbed suture group, there were two cases (1.9%) of postoperative complications in the multifilament suture group (P = 0.0272). We demonstrated that the use of the barbed suturing device for laparoscopic peritoneal closure was safe and feasible.

Robotic assisted sleeve lobectomy with the use of barbed sutures

Anastomosis in bronchoplasty using continuous suturing has become widely accepted. However, especially in VATS and robotic assisted thoracic surgery (RATS) it is difficult to maintain a continuous traction of suture over the circumference. In addition, the lack of haptic feedback on the current robotic systems might even further complicate the precise and constant maintenance of traction. Recent reports of using absorbable barbed suture materials in open and VATS surgery were published with promising results. We adopted and standardized the application of barbed sutures (Stratafix, Jonhson & Johnson, USA). There were no intraoperative difficulties such as cutting, loosening or tailing the suture.

A Novel Knotless Barbed Suture Technique for Traumatic Thoracolumbar Fracture in Posterior Surgery.

Surgical wound closure directly influences spinal surgical efficiency and several postoperative complications. The traditional suture technique is time-consuming and associated with greater rates of complications. Bidirectional absorbable barbed sutures seem to compensate for some of the limitations of traditional suture; however, they rarely are reported in spinal surgery. We designed a novel suture technique for use in thoracolumbar spinal surgery. The data of 189 patients with traumatic thoracolumbar fractures were analyzed between bidirectional barbed suture closure and traditional interrupted suture closure. Data of operative time, wound closure time, length of incision, intraoperative blood loss, complications of wound dehiscence and postoperative hematoma, cost, and neurologic status were collected. No significant differences were observed in the baseline demographics of included patients. Compared with the traditional suturing group, the barbed sutures decreased the mean operative time (P= 0.037), suture time (P < 0.01), and mean suturing time (P < 0.01) significantly, although no statistically significant differences were found in blood loss (P= 0.724) and neurologic functional scores (preoperative: P= 0.901; 3 months after surgery: P= 0.208; final follow-up assessments: P= 0.163), and no statistically significant differences were found in rates of postoperative infection, hematoma, and wound dehiscence. Our findings suggest that the novel knotless barbed suture has comparable strength to traditional sutures, with the advantage of less suturing time. It is an efficient, safe technique, and alternative choice for patients with thoracolumbar fracture after posterior surgery.

Self-retaining barbed suture reduces warm ischemia time during laparoscopic partial nephrectomy

Objective: To evaluate the efficacy and safety of self-retaining barbed suture in renorrhaphy during laparoscopic partial nephrectomy by comparing surgical outcomes in a prospective randomized manner.Material and methods: From July 2014 to July 2015, a total of 60 patients with T1 renal tumor were randomized into two equal groups: self-retaining barbed suture (SRBS) and conventional absorbable polyglactin suture (non-SRBS group). All patients were treated by retroperitoneal laparoscopic partial nephrectomy. One surgeon with high volume experience performed all procedures. The patient demographics and perioperative outcomes were compared.Results: The patient demographics and tumor characteristics were comparable. The mean tumor size and R.E.N.A.L. scores were comparable between the two groups. LPN was successfully accomplished in all patients without open conversion. The warm ischemia and renorrhaphy times were significantly shorter in the SRBS group (18.8 ± 8.2 vs. 22.9 ± 7.3 min, P = .04; 10.4 ± 3.7 vs. 13.8 ± 5.6 min, P = .01). The minor complication rate was 13.3% vs. 10.0%, which was comparable. No major complication occurred.Conclusions: The randomized controlled trial demonstrates that SRBS for renorrhaphy during retroperitoneal laparoscopic partial nephrectomy is safe and efficient. Application of barbed suture simplifies the parenchymal repair procedure and reduces warm ischemia time in comparison with conventional suture.

Laparoscopic proximal gastrectomy with hinged double flap method using knotless barbed absorbable sutures: A case series

BackgroundIntracorporeal reconstruction following laparoscopic proximal gastrectomy is technically challenging. The aim of this study was to investigate the use of knotless barbed absorbable sutures in esophagogastrostomy closure using the hinged double flap method. Design & methodThe subjects comprised patients with gastric cancer who were scheduled to undergo laparoscopic proximal gastrectomy. The V-Loc™ 180 wound closure device (V-Loc; Covidien, Mansfield, MA, USA) was used for all laparoscopic esophagogastrostomy closures. Between January 2015 and November 2016, 13 patients were enrolled. ResultsThe mean suturing time was 109.6 min. Median hospital stay was 14 days. One anastomotic minor leakage occurred in an esophagogastrostomy and it was managed conservatively. Twelve of 13 patients did not exhibit any symptoms of reflux esophagitis. ConclusionThese results suggest the use of the unidirectional barbed absorbable suture is safe and produce reproducible results for esophagogastrostomy closure using the hinged double flap method.

The Efficacy of Midline Barbed Absorbable Sutures in Progressive Tension Closure of Abdominal Flap Donor Sites

The Efficacy of Midline Barbed Absorbable Sutures in Progressive Tension Closure of Abdominal Flap Donor Sites

Facial Rejuvenation Enhancing Cheek Lift.

Supported by recent literature on the signs of aging of the middle and lower face, our clinical research has documented a loss of volume of the deep structural components of the central face and a progressive descent of the nasolabial fat and the jowl fat, leading to facial fragmentation. The signs that appear around the age of 45 to 50 years are well targeted by the mini-invasive technique described here. We focused on refitting the jowl fat and the nasolabial fat associated with cutaneous tightening. The use of absorbable barbed sutures (Quill) led to significant improvements, enabling the fitting of fat on fat. In the past 4 years, 167 operations were performed using this technique. The clinical results were very satisfactory, yielding a natural effect caused by the mobilization and strong fixation of the nasolabial fat and the jowl fat in the direction opposite to their displacement.

Endoscopic hand-suturing for defect closure after gastric endoscopic submucosal dissection: a pilot study in animals and in humans.

Background and study aims Mucosal suturing enables reliable and optimal defect closure after endoscopic treatments. We developed and investigated the feasibility of endoscopic hand-suturing (EHS) after gastric endoscopic submucosal dissection (ESD) in porcine in vivo models and in human clinical cases. Patients and methods EHS involving continuous suturing of the mucosal layers using a through-the-scope needle-holder and absorbable barbed suture, was performed after gastric ESD in six live pigs and in eight consecutive patients. Success rates, adverse events, and suture maintenance were subsequently investigated. Results EHS was successfully completed in all six pigs and eight patients (100 %) without severe adverse events. However, at 1 week postoperatively the suture closures had not been maintained in all six porcine cases and in the first four clinical cases. In the later four clinical cases, wider and tight suturing of the mucosal edges ensured that the defects remained closed until postoperative week 4. Conclusion EHS is a feasible procedure that may facilitate secure and refined endoscopic surgeries. Mucosal closure in such cases can be maintained using firm suturing.Clinical trial number: UMIN000017125.

23: Laparoscopic paravaginal defect repair using delayed absorbable barbed suture

23: Laparoscopic paravaginal defect repair using delayed absorbable barbed suture

P1.08-053 Thoracoscopic Partial Resection for Peripheral Pulmonary Nodules without Using Stapler

Advances in radiologic studies, such as high resolution computed tomography (HRCT), have enabled frequent detection of small lung nodules. Accordingly, opportunity for sublobar resections for small lesions has increased. Recently, we have introduced thoracoscopic partial resection for peripheral pulmonary small nodules without using stapler to reduce the cost of operation. After detecting the peripheral nodules, partial resection was performed with electrocautery and two different methods of surface sealing were followed. Coagulation method (C method) with SOFT COAG alone and Coagulation-suturing method (CS method) with SOFT COAG combined with continuous suturing by an absorbable barbed suture. The clinical outcome of the two methods was retrospectively compared in this study. C method was performed in 19 lesions of 18 cases and CS method was performed in 17 lesions of 16 cases. Primary lung cancer was most frequent as 19 lesions of 18 cases. There was no significant difference between the two groups in size and depth of the lesions. Operation time was significantly longer in CS method than in C method. Postoperative air leakage was complicated to 4 cases in C method and one of them needed re-do surgery, whereas only one case in CS method had temporary air leakage. Postoperative computed tomography revealed cavitation in 3 cases of C method and in 4 cases of CS method all without related symptoms. There was no local recurrence in resected sites. C method was technically easy to perform, but air leakage may be possibly prolonged after surgery. CS method may have an advantage of less air leakage than C method, but technical learning is important to shorten operation time.

Photometric analysis of absorbable barbed suture for periareolar closure in mastopexy

Photometric analysis of absorbable barbed suture for periareolar closure in mastopexy

Self-retaining barbed suture during laparoscopic partial nephrectomy

ObjectiveThis study was conducted to investigate the safety and feasibility of self-retaining barbed absorbable suture application in laparoscopic partial nephrectomy (LPN). Materials and methodsFrom January 2010 to September 2014, 38 cases of LPN were performed at Changhua Christian Hospital, Changhua, Taiwan. The patients were divided into two groups: the nonself-retaining barbed suture (non-SRBS) group (n = 21) and the SRBS group (n = 17). There was no significant difference in age, RENAL (Radius, Exophytic/Endophytic properties, Nearness of the tumor to the collecting system or sinus, Anterior/Posterior, Location relative to polar lines) nephrometry score, and tumor type between the two groups. Clinical data and outcomes were analyzed retrospectively. ResultsAll 38 cases of LPN were successfully performed, without conversion to open surgery or serious intraoperative complications. In the SRBS group, renorrhaphy time and length of hospital stay were significantly shorter than those of the non-SRBS group (p = 0.015 and p = 0.009, respectively). ConclusionsThe application of SRBS in LPN could shorten renorrhaphy time and hospital stay with good safety and feasibility.

Periareolar Closure With Barbed Sutures.

Periareolar closure in augmentation, mastopexy, and breast reduction has evolved dramatically over the past 10 years with changes in technique and technology. Plastic surgeons have tried many techniques from simple purse string closures using permanent sutures1 to interlocking purse string closures with GORE-TEX2 (Gore Medical, Newark, DE) or absorbable sutures. Running and interrupted suture techniques or combinations of both have all been utilized. I began using absorbable barbed sutures in 2007 for abdominoplasty3,4 to eliminate knot tying and decrease complications associated with permanent sutures such as knot palpability, extrusion, and infection.5 I then applied this new suture technology to surgical closures of the breast and developed a technique for periareolar closure that has improved my efficiency. First the areolar is marked into eight quadrants. A surgical staple is placed at the 12 o'clock position to stabilize the tissues. Starting at the 6 o'clock position of the areola, a double-armed 2-0 polydioxanone (PDO) Quill (Surgical Specialties Corporation, Wyomissing, PA) suture is looped to include the subdermal areolar tissues and the two corners of the adjacent skin comprising the top of the vertical limb. Each arm of the barbed suture is deployed in the subdermal plane and passed up to the 12 o'clock position in an interlocking fashion, …

SMAS Plication with Absorbable Barbed Sutures

SMAS Plication with Absorbable Barbed Sutures

Robotic zero ischemia partial nephrectomy: step by step surgical technique with tips and tricks

Robotic zero ischemia partial nephrectomy: step by step surgical technique with tips and tricks Abdullah Erdem Canda,1 Mevlana Derya Balbay2 1Yildirim Beyazit University, School of Medicine, Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, 2Memorial Sisli Hospital, Department of Urology, Istanbul, Turkey Abstract: Currently, most renal cell carcinoma cases are detected incidentally as small renal masses during radiologic imaging, such as abdominal ultrasound or computed tomography, and partial nephrectomy is being increasingly performed for these lesions. There has been a worldwide increase in minimally invasive surgical approaches, and robotic partial nephrectomy (RPN) in particular has the advantages of more rapid tissue dissection, reconstruction, intracorporeal suturing, three-dimensional optical magnification, dexterity in motion, and ability to perform tremor-free and delicate movements with three independent robotic arms. Renal hilar clamping during RPN decreases bleeding, but warm ischemia might negatively impact renal function. However, with sufficient surgical experience in robotic kidney surgery, zero ischemic or off-clamp RPN might be a safe and feasible minimally invasive surgical approach that has the advantage of avoiding complete renal ischemia, thus avoiding a decrease in renal function particularly in small, less complex, peripherally located, exophytic renal masses less than 3 cm in size. Currently available absorbable barbed sutures could further facilitate performing internal and external renorraphy, as could fibrin and tissue sealants that may also be used for hemostasis. This approach might be particularly important in patients with underlying kidney disease. Keywords: robotic partial nephrectomy, zero ischemia, renal cell carcinoma, small renal masses, minimally invasive surgery, surgical technique

Recurrent Foley catheter puncture and displacement: a complication of the use of barbed polyglyconate suture to facilitate vesicourethral anastomosis during robot-assisted radical prostatectomy

Robot-assisted radical prostatectomy (RARP) has been rapidly adopted as an option for surgical management of clinically localized prostate cancer. A challenging aspect of the operation is producing a watertight vesicourethral anastomosis (VUA). The use of unidirectional barbed polyglyconate absorbable suture (V-Loc 180, Covidien, Mansfield, MA, USA) for posterior reconstruction and VUA during RARP was initially described in 2010 [1, 2] and has been shown to safely improve anastomotic times [3–6]. We describe a unique postoperative complication of the use of barbed suture during RARP: recurrent puncture and displacement of the urethral catheter.

A Multicenter Randomized Controlled Trial Comparing Absorbable Barbed Sutures Versus Conventional Absorbable Sutures for Dermal Closure in Open Surgical Procedures

Barbed sutures were developed to reduce operative time and improve security of wound closure. The authors compare absorbable barbed sutures (V-Loc, Covidien, Mansfield, Massachusetts) with conventional (smooth) absorbable sutures for soft tissue approximation. A prospective multicenter randomized study comparing barbed sutures with smooth sutures was undertaken between August 13, 2009, and January 31, 2010, in 241 patients undergoing abdominoplasty, mastopexy, and reduction mammaplasty. Each patient received barbed sutures on 1 side of the body, with deep dermal sutures eliminated or reduced. Smooth sutures with deep dermal and subcuticular closure were used on the other side as a control. The primary endpoint was dermal closure time. Safety was assessed through adverse event reporting through a 12-week follow-up. A total of 229 patients were ultimately treated (115 with slow-absorbing polymer and 114 with rapid-absorbing polymer). Mean dermal closure time was significantly quicker with the barbed suture compared with the smooth suture (12.0 vs 19.2 minutes; P<.001), primarily due to the need for fewer deep dermal sutures. The rapid-absorbing barbed suture showed a complication profile equivalent to the smooth suture, while the slow-absorbing barbed suture had a higher incidence of minor suture extrusion. Barbed sutures enabled faster dermal closure quicker than smooth sutures, with a comparable complication profile. 1.

A new, simple technique for gradual primary closure of fasciotomy wounds.

The aim of this study was to demonstrate a new, easy and safe technique, which has not been defined in the literature previously, that enables the gradual primary closure of fasciotomy wounds using barbed sutures. The technique was performed on five patients who presented with fasciotomy wounds on both upper and lower extremities, varying in size, observed after compartment syndrome due to different causes. The average width of the defects for which primary closure was planned was 8.8 cm. Following the fasciotomy incision, absorbable barbed sutures were inserted through the dermal tissue around the wound similar to that of a subcuticular closure, but left loose, after which closed dressing was applied. During the clinical follow-up, with the decrease in tissue edema and tightness around the wound, the barbed suture was tightened at bedside every 48-72 hours. At the end of this gradual closure, all the fasciotomy defects were primarily closed within an average of 8.6 days. All the patients had complete and uncomplicated primary closure with the exception of one with high-voltage electrical burn injury, who developed necrosis in the distal part of the defect, and was treated by secondary healing. The gradual fasciotomy closure technique with barbed suture seems to be an easy, rapid and effective method.

Application of bidirectional barbed absorbable suture in retroperitoneoscopic pyeloureteroplasty

Objective To investigate the safety and feasibility of bidirectional barbed absorbable suture application in retroperitoneoscopic pyeloureteroplasty.Methods Between March 2011 and June 2013,35 cases of retroperitoneoscopic pyeloureteroplasty were performed in our hospital:5/0 adsorbable suture was used in 21 cases (group A),and bidirectional barbed absorbable suture was used in 14 cases (group B).In group A,there were 12 males and 9 females aged 6-18 years (mean 14.6 years).In group B,there were 8 males and 7 females aged 7-25 years (mean 16.8 years).All cases were diagnosed as having ureteropelvic junction stricture by B-ultrasound,three dimensional CT urography (CTU) or magnetic resonance urography (MRU).Methods All 35 cases of retroperitoneoscopic pyeloureteroplasty were successfully performed,without conversion to open surgery and important intraoperative complications.In group A,the operative time was (79.5 ± 21.4) min,the blood loss was (18.5 ± 21.2) ml,and suture time was (22.4 ±3.2) miu.In group B,the operative time was (61.3 ± 13.1) min,the blood loss was (120.4 ± 21.1) ml,and suture time was (11.6 ±2.7) min,without operative blood transfusion.In two groups,hospital stay was 5-7 days (mean 6 days).The follow-up duration was 1 to 28 months.No re-stenosis of ureter was found any more,and there was no sutures calculi also.Conclusion The application of bidirectional barbed absorbable suture in retroperitoneoscopic pyeloureteroplasty could shorten suture time and warm-ischemia time,with good safety and feasibility,and is worthy.of being applicated generally in clinic. Key words: Bidirectional barbed absorbables suture line; Retroperitoneoscopy; Pyeloureteroplasty