Bidirectional Barbed Suture in Laparoscopic Myomectomy: Clinical Features

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; Monocryl (TM)-1; Ethicon Inc., Somerville, NJ) or intracorporeal (polyglactin 910; Vicryl (TM)-1; Ethicon Inc.) knots or a bidirectional knotless barbed suture (Quill (TM)-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.