Study Objective: To estimate the effectiveness of unidirectional barbed
suture and continuous suture with intracorporeal knots in the repair of uterine wall defects during laparoscopic myomectomy.
Design: Randomized clinical study.
Setting: San Martino Hospital –Genoa University –Italy.
Patients: This study enrolled 39 women who underwent laparoscopic myomectomy.
Interventions: according to the randomization, the uterine wall defects
were closed either with the traditional sutures in the traditional way (group < br />V) 19 cases or a barbed suture (group L) 20 cases.
Measurements and Main Results: The time required to suture the uterine
wall defect was significantly lower in group L [The barbed sutures group]
(9.65 + 1.57 minutes) than in group V [The traditional sutures group] (18.11
+ 1.41 minutes; p < 0.001). The total operative time was also significantly
decreased on the use of barbed sutures (64 + 8.77 minutes versus 95.32 +
6.57 minutes) with a P value of < 0.001. The intraoperative blood loss was
significantly lower in group L than in group V (P value of < 0.001). The
degree of surgical difficulty [evaluated by the use of a VAS scale ranging
from 1 (low difficulty) to 10 (high difficulty)] was significantly lower in
group L ( 3.15 + 0.88) than in group V (5.95 + 1.81) with a P value of
< 0.001.
Conclusion: The unidirectional knotless barbed sutures significantly facilitated the suturing of uterine wall defects during laparoscopic myomectomy. When compared with traditional suture with intracorporeal knots, the
barbed suture reduces the time required to suture the uterine wall defect,
reduces the total operative time and the intraoperative blood loss.