Abstract
Background
The aim of this study was to investigate the safety and efficacy of self-retaining barbed sutures in comparison with monofilament clip-fixated sutures for rectal wall closure in transanal endoscopic microsurgery.
Methods
Horizontal full-thickness wall defects (3.5 cm) of cattle rectal specimens were closed via transanal endoscopic microsurgery using a monofilament suture with clips at the end (Surgipro® 2/0; Covidien, Mansfield, MA, USA, n = 25) or a self-retaining barbed suture (V-Loc™ 180 3/0; Covidien, Mansfield, MA, USA, n = 25). The primary endpoint was the pneumatic leakage pressure of the suture line. As a secondary endpoint, suture time was evaluated.
Results
The median pneumatic leakage pressure for barbed sutures was 45.5 mbar (range 17–106 mbar) and 33.5 mbar (range 19–106 mbar) for monofilament sutures (p = 0.58). A pneumatic leak at a critical pressure below 25 mbar occurred in 3 cases with barbed sutures and in 7 cases with monofilament sutures (p = 0.29). Median suturing time [19:25 min:s (range 12:00–33:30) vs. 20:41 (17:00–28:33), p = 0.23] did not differ between the two groups.
Conclusions
Barbed sutures display the same bursting pressure as monofilament sutures and their use for rectal wall closure seems feasible.
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References
Morino M, Arezzo A, Allaix ME (2013) Transanal endoscopic microsurgery. Tech Coloproctol 17(Suppl 1):S55–S61
Saclarides TJ (2007) TEM/local excision: indications, techniques, outcomes, and the future. J Surg Oncol 96:644–650
Ramirez JM, Aguilella V, Arribas D, Martinez M (2002) Transanal full-thickness excision of rectal tumours: should the defect be sutured? A randomized controlled trial. Colorectal Dis 4:51–55
Milone M, Di Minno MN, Galloro G et al (2013) Safety and efficacy of barbed suture for gastrointestinal suture: a prospective and randomized study on obese patients undergoing gastric bypass. J Laparoendosc Adv Surg Tech A 23:756–759
Facy O, De Blasi V, Goergen M, Arru L, De Magistris L, Azagra JS (2013) Laparoscopic gastrointestinal anastomoses using knotless barbed sutures are safe and reproducible: a single-center experience with 201 patients. Surg Endosc 27:3841–3845
Costantino F, Dente M, Perrin P, Sarhan FA, Keller P (2013) Barbed unidirectional V-Loc 180 suture in laparoscopic Roux-en-Y gastric bypass: a study comparing unidirectional barbed monofilament and multifilament absorbable suture. Surg Endosc 27:3846–3851
Xu H, Chaturvedi R, Cheng Y et al (2004) Spermine oxidation induced by helicobacter pylori results in apoptosis and DNA damage: implications for gastric carcinogenesis. Cancer Res 64:8521–8525
Griffiths PR, Yang HS, Li QB et al (2004) Discrimination of normal and malignant gastric tissues with FTIR spectroscopy and principal component analysis. Guang Pu Xue Yu Guang Pu Fen Xi 24:1025–1027
Bussière FI, Chaturvedi R, Cheng Y (2005) Spermine causes loss of innate immune response to helicobacter pylori by inhibition of inducible nitric-oxide synthase translation. J Biol Chem 280:2409–2412
Buess G, Hutterer F, Theiss J, Böbel M, Isselhard W, Pichlmaier H (1984) A system for a transanal endoscopic rectum operation. Chirurg 55:677–680
Barendse RM, Dijkgraaf MG, Rolf UR et al (2013) Colorectal surgeons’ learning curve of transanal endoscopic microsurgery. Surg Endosc 27:3591–3602
Rashid RM, Sartori M, White LE, Villa MT, Yoo SS, Alam M (2007) Breaking strength of barbed polypropylene sutures: rater-blinded, controlled comparison with nonbarbed sutures of various calibers. Arch Dermatol 143:869–872
Nemecek E, Negrin L, Beran C, Nemecek R, Hollinsky C (2013) The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study. Surg Endosc 27:3830–3834
Pham KN, Sack BS, O’Connor RC et al (2013) V-Loc urethro-intestinal anastomosis during robotic cystectomy with orthotopic urinary diversion. Can Urol Assoc J 7:E663–E666
Massoud W, Thanigasalam R, El Hajj A et al (2013) Does the use of a barbed polyglyconate absorbable suture have an impact on urethral anastomosis time, urethral stenosis rates, and cost effectiveness during robot-assisted radical prostatectomy? Urology 82:90–94
Liatsikos E, Knoll T, Kyriazis I et al (2013) Unfavorable outcomes of laparoscopic pyeloplasty using barbed sutures: a multi-center experience. World J Urol 31:1441–1444
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Wilhelm, P., Storz, P., Axt, S. et al. Use of self-retaining barbed suture for rectal wall closure in transanal endoscopic microsurgery. Tech Coloproctol 18, 813–816 (2014). https://doi.org/10.1007/s10151-014-1138-8
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DOI: https://doi.org/10.1007/s10151-014-1138-8