Surgical Endoscopy

, Volume 27, Issue 10, pp 3846–3851 | Cite as

Barbed unidirectional V-Loc 180 suture in laparoscopic Roux-en-Y gastric bypass: a study comparing unidirectional barbed monofilament and multifilament absorbable suture

  • Federico CostantinoEmail author
  • Mario Dente
  • Philippe Perrin
  • Fadi Abou Sarhan
  • Philippe Keller



This study aimed primarily to evaluate the safety of digestive running suture (in gastrojejunal and antecolic jejunojejunal anastomosis closure) using unidirectional absorbable barbed suture (V-Loc 180) in laparoscopic Roux-en-Y gastric bypass (LRYGB) and secondarily to assess the efficacy of V-Loc 180 in reducing operative time.


A prospective cohort study of 315 consecutive patients who underwent LRYGB was performed between October 2009 and October 2012 using an identical procedure technique. For the first 76 patients, a multifilament absorbable suture was used to assess the gastrojejunal anastomosis and the antecolic jejunal suture. For the following 239 patients, a unidirectional barbed monofilament suture was used. Data including operative time, time required for gastric pouch creation, time spent in both anastomoses constructions, conversion rate, and complications were prospectively recorded.


The postoperative complications did not differ significantly between the two groups. Early complications were observed for 1 patient (1.3 %) in the multifilament group and for 14 patients (5.8 %) in the barbed procedure group (p > 0.05). Late complications were observed for 1 patient (1.3 %) in the multifilament group and for 5 patients (2 %) in the barbed procedure group (p > 0.05). A shortened operative time was achieved in the barbed suture group. The mean operative time was 74.3 ± 15.3 min in the Vicryl group versus 62.7 ± 15.5 min in the V-Loc group (p < 0.05). The mean operative time required to fashion the gastrojejunal anastomosis was 21.3 ± 6.3 min in the Vicryl group versus 17.4 ± 5.1 min in the V-Loc group (p < 0.05). The mean operative time required to fashion the jejunojejunal anastomosis was 21.4 ± 4.9 min in the Vicryl group versus 15.2 ± 5.5 min in the V-Loc group (p < 0.05).


The authors’ experience has demonstrated that the use of interlocked V-Loc suture during LRYGB anastomosis appears to be safe and efficient. The findings show a shortened total operative time in terms of single gastrojejunal or jejunojejunal anastomosis time. No statistically significant differences in early or late postoperative complications were observed between the V-Loc and multifilament absorbable suture patients.


Complications rate  Laparoscopic gastric bypass  Laparoscopic suture  Obesity surgery 



The authors are grateful to Christopher Burel and Guy Temporal for their proofreading of the manuscript.


Federico Costantino, Mario Dente, Philippe Perrin, Fadi Abou Sarhan, and Philippe Keller have no conflicts of interest or financial ties to disclose.


  1. 1.
    World Health Organization (2011) Fact sheet number 311. Retrieved May 2011 from
  2. 2.
    Flegal KM, Carroll MD, Ogen CL, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723–1727PubMedCrossRefGoogle Scholar
  3. 3.
    Fisher BL, Schauer P (2002) Medical and surgical options in the treatment of severe obesity. Am J Surg 184:9S–16SPubMedCrossRefGoogle Scholar
  4. 4.
    Jones KB Jr (2010) Commentary re: laparoscopic versus open gastric bypass. Obes Surg 20:380–382PubMedCrossRefGoogle Scholar
  5. 5.
    Pope GG, Birkmeyer JD, Finlayson SR (2002) National trends in utilization and in-hospital outcome of bariatric surgery. J Gastrointest Surg 6:855–860PubMedCrossRefGoogle Scholar
  6. 6.
    Santry HP, Gillen DL, Lauderdale DS (2005) Trends in bariatric surgical procedures. JAMA 249:1909–1917CrossRefGoogle Scholar
  7. 7.
    Nguyen NT, Rivers R, Wolfe BM (2003) Factors associated with operative outcomes in laparoscopic gastric bypass. J Am Coll Surg 197:548–555PubMedCrossRefGoogle Scholar
  8. 8.
    Schauer P, Ikramuddin S, Hammad G, Gourash W (2003) The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Surg Endosc 17:212–215PubMedCrossRefGoogle Scholar
  9. 9.
    NIH Consensus Development Conference Panel (1991) Gastrointestinal surgery for severe obesity. Ann Intern Med 115:956–961CrossRefGoogle Scholar
  10. 10.
    The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium (2009) Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med 361:445–454CrossRefGoogle Scholar
  11. 11.
    Lönroth H, Dalenbäck J, Haglind E, Lundell L (1996) Laparoscopic gastric bypass: another option in bariatric surgery. Surg Endosc 10:636–638PubMedCrossRefGoogle Scholar
  12. 12.
    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRefGoogle Scholar
  13. 13.
    Torgerson JS, Sjöström L (2001) The Swedish Obese Subjects (SOS) study: rationale and results. Int J Obes Relat Metab Disord 25(Suppl 1):S2–S4PubMedCrossRefGoogle Scholar
  14. 14.
    Farrell MT, Haggerty SP, Overby DW, Khonn GP, Richardson WS, Fanelli RD (2009) Clinical application of laparoscopic bariatric surgery: an evidence-based review. Surg Endosc 23:930–949PubMedCrossRefGoogle Scholar
  15. 15.
    Costantino F, Mutter D, D’Agostino J, Dente M, Leroy J, Wu HS, Marescaux J (2012) Mentored trainees obtain comparable operative results to experts in complex laparoscopic colorectal surgery. Int J Colorectal Dis 27:65–69PubMedCrossRefGoogle Scholar
  16. 16.
    Tyner RP, Clifton GT, Fenton SJ (2012) Hand-sewn gastrojejunostomy using knotless unidirectional barbed absorbable suture during laparoscopic gastric bypass. Surg Endosc 27(4):1360–1366PubMedCrossRefGoogle Scholar
  17. 17.
    Roslan M, Markuszewski MM, Kłącz J, Krajka K (2012) Laparoendoscopic single-site transvesical ureteroneocystostomy for vesicoureteral reflux in an adult: a one-year follow-up. Urology 80:719–723. doi: 10.1016/j.urology.2012.06.028 PubMedCrossRefGoogle Scholar
  18. 18.
    Angioli R, Plotti F, Montera R, Damiani P, Terranova C, Oronzi I, Luvero D, Scaletta G, Muzii L, Panici PB (2012) A new type of absorbable barbed suture for use in laparoscopic myomectomy. Int J Gynaecol Obstet 117:220–223. doi: 10.1016/j.ijgo.2011.12.023 PubMedCrossRefGoogle Scholar
  19. 19.
    Oni G, Brown SA, Kenkel JM (2012) A comparison between barbed and nonbarbed absorbable suture for fascial closure in a porcine model. Plast Reconstr Surg 130:536e–541eGoogle Scholar
  20. 20.
    Takayama S, Nakai N, Shiozaki M, Ogawa R, Sakamoto M, Takeyama H (2012) Use of barbed suture for peritoneal closure in transabdominal preperitoneal hernia repair. World J Gastrointest Surg 4:177–179PubMedCrossRefGoogle Scholar
  21. 21.
    De Blasi V, Facy O, Goergen M, Poulain V, De Magistris L, Azagra JS (2013) Barbed versus usual suture for closure of the gastrojejunal anastomosis in laparoscopic gastric bypass: a comparative trial. Obes Surg 23:60–63. doi: 10.1007/s11695-012-0763-4 PubMedCrossRefGoogle Scholar
  22. 22.
    Ruiz de Adana JC, Hernández Matías A, Hernández Bartolomé M, Manzanedo Romero I, Leon Ledesma R, Valle Rubio A, López Herrero J, Limones Esteban M (2009) Risk of gastrojejunal anastomotic stricture with multifilament and monofilament sutures after hand-sewn laparoscopic gastric bypass: a prospective cohort study. Obes Surg 19:1274–1277PubMedCrossRefGoogle Scholar
  23. 23.
    Podnos YD, Jimenez JC, Wilson SE, Stevens Cm, Nguyen NT (2003) Complications after laparoscopic gastric bypass: a review of 3,464 cases. Arch Surg 138:957–961PubMedCrossRefGoogle Scholar
  24. 24.
    Makar SR, Penna M, Karthikesalingam A, Hashemi M (2012) The impact of hospital volume on clinical outcome following bariatric surgery. Obes Surg 22:1126–1134. doi: 10.1007/s11695-012-0639-7 CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Federico Costantino
    • 1
    Email author
  • Mario Dente
    • 2
  • Philippe Perrin
    • 1
  • Fadi Abou Sarhan
    • 1
  • Philippe Keller
    • 1
  1. 1.Hôpital Civil de ColmarColmar CedexFrance
  2. 2.Hôpital Simone VeilEaubonneFrance

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