Skip to main content

Advertisement

SpringerLink
Log in

Barbed versus traditional suture for enterotomy closure after laparoscopic right colectomy with intracorporeal mechanical anastomosis: a case–control study

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Our aim was to establish the safety and efficacy of barbed suture for enterotomy closure after laparoscopic right colectomy with intracorporeal anastomosis. This study included 47 patients who underwent laparoscopic right hemicolectomy with intracorporeal mechanical anastomosis and barbed suture enterotomy closure (barbed suture closure—BSC) for adenocarcinoma (with the exception of T4 lesions and metastasis), compared with 47 matched patients who underwent laparoscopic right hemicolectomy with intracorporeal mechanical anastomosis and conventional suture enterotomy closure (conventional suture closure—CSC) during the same period. Controls were matched for stage, age, and gender via a statistically generated selection of all laparoscopic right hemicolectomies performed from January 2009 until December 2015. There was no difference between the two groups in terms of age, sex, BMI, ASA, co-morbidity, previous abdominal surgery, cancer site and cancer staging. In terms of operating time (median 120 min for BSC and 127.5 min for CSC), histopathological results, surgical site complications (2.1% for BSC and 8.5% for CSC), hospitalization (median 6 days for BSC and 5 days for CSC), readmission rate (0%), there were no differences between the groups (p > 0.05). No significant differences were noted between the two groups in terms of the postoperative course. Our results support that the use of knotless barbed sutures for enterotomy closure after laparoscopic right colectomy with intracorporeal mechanical anastomosis is safe and reproducible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schlinkert RT (1991) Laparoscopic-assisted right hemicolectomy. Dis Colon Rectum 34:1030–1031

    Article  CAS  Google Scholar 

  2. Tinmouth J, Tomlinson G (2004) Laparoscopically assisted versus open colectomy for colon cancer. N Engl J Med 351(9):933–934

    Article  CAS  Google Scholar 

  3. Guillou P, Quirke P, Thorpe H et al (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre randomized controlled trial. Lancet 365:1718–1726

    Article  Google Scholar 

  4. Lacy AM, Garcia-Valdecasas JC, Pique JM et al (1995) Short term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer. Surg Endosc 9:1101–1105

    CAS  PubMed  Google Scholar 

  5. The COLOR Study Group (2000) COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer. Dig Surg 17:617–622

    Article  Google Scholar 

  6. Yeo HL, Isaacs AJ, Abelson JS, Milsom JW, Sedrakyan A (2016) Comparison of open, laparoscopic, and robotic colectomies using a large national database: outcomes and trends related to surgery center volume. Dis Colon Rectum 59(6):535–542

    Article  Google Scholar 

  7. Jamali FR, Soweid AM, Dimassi H et al (2008) Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 143(8):762–767

    Article  Google Scholar 

  8. Hellan M, Anderson C, Pigazzi A (2009) Extracorporeal versus intracorporeal anastomosis for laparoscopic right hemicolectomy. JSLS 13(3):312–317

    PubMed  PubMed Central  Google Scholar 

  9. Scatizzi M, Kröning KC, Borrelli A et al (2010) Extracorporeal versus intracorporeal anastomosis after laparoscopic right colectomy for cancer: a case-control study. World J Surg 34(12):2902–2908

    Article  Google Scholar 

  10. Fabozzi M, Allieta R, Contul RB et al (2010) Comparison of short- and medium-term results between laparoscopically assisted and totally laparoscopic right hemicolectomy: a case-control study. Surg Endosc 24(9):2085–2091

    Article  Google Scholar 

  11. Grams J, Tong W, Greenstein AJ et al (2010) Comparison of intracorporeal versus extracorporeal anastomosis in laparoscopic-assisted hemicolectomy. Surg Endosc 24(8):1886–1891

    Article  Google Scholar 

  12. Chaves JA, Idoate CP, Fons JB et al (2011) A case-control study of extracorporeal versus intracorporeal anastomosis in patients subjected to right laparoscopic hemicolectomy. Cir Esp 89(1):24–30

    Article  Google Scholar 

  13. Feroci F, Lenzi E, Garzi A et al (2013) Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis. Int J Colorectal Dis 28(9):1177–1186

    Article  Google Scholar 

  14. Cirocchi R, Trastulli S, Farinella E et al (2013) Intracorporeal versus extracorporeal anastomosis during laparoscopic right hemicolectomy—systematic review and meta-analysis. Surg Oncol 22(1):1–13

    Article  Google Scholar 

  15. Ritter EM, Mcclusky DA, Gallagher AG et al (2005) Real-time objective assessment of knot quality with a portable tensiometer is superior to execution time for assessment of laparoscopic knot-tying performance. Surg Innov 12:233–237

    Article  Google Scholar 

  16. Einarsson JI, Chavan NR, Suzuki Y (2011) Use of bidirectional barbed suture in laparoscopic myomectomy: evaluation of perioperative outcomes, safety, and efficacy. J Minim Invasive Gynecol 18:92–95

    Article  CAS  Google Scholar 

  17. Naki MM, Api O, Acioglu HC (2010) Comparative study of a barbed suture, poliglecaprone and stapler in Pfannenstiel incisions performed for benign gynecological procedures: a randomized trial. Acta Obstet Gynecol Scand 89:1473–1477

    Article  Google Scholar 

  18. Siedhoff MT, Yunker AC, Steege JF (2011) Decreased incidence of vaginal cuff dehiscence after laparoscopic closure with bidirectional barbed suture. J Minim Invasive Gynecol 18:218–223

    Article  Google Scholar 

  19. Warner JP, Gutowski KA (2009) Abdominoplasty with progressive tension closure using a barbed suture technique. Aesthet Surg J 29:221–225

    Article  Google Scholar 

  20. Murtha AP, Kaplan AL, Paglia MJ (2006) Evaluation of a novel technique for wound closure using a barbed suture. Plast Reconstr Surg 117:1769–1780

    Article  CAS  Google Scholar 

  21. Tewari AK, Srivastava A, Sooriakumaran P (2010) Use of a novel absorbable barbed plastic surgical suture enables a ‘‘self-cinching’’ technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times. J Endourol 24:1645–1650

    Article  Google Scholar 

  22. Kaul S, Sammon J, Bhandari A (2010) A novel method of urethrovesical anastomosis during robot-assisted radical prostatectomy using a unidirectional barbed wound closure device: feasibility study and early outcomes in 51 patients. J Endourol 24:1789–1793

    Article  Google Scholar 

  23. Williams SB, Alemozaffar M, Lei Y (2010) Randomized controlled trial of barbed polyglyconate versus polyglactin suture for robot-assisted laparoscopic prostatectomy anastomosis: technique and outcomes. Eur Urol 58:875–881

    Article  CAS  Google Scholar 

  24. Zorn KC, Trinh Q-D, Jeldres C (2012) Prospective randomized trial of barbed polyglyconate suture to facilitate vesico-urethral anastomosis during robot-assisted radical prostatectomy: time reduction and cost benefit. BJU Int 109:1526–1532

    Article  Google Scholar 

  25. Gililland JM, Anderson LA, Sun G (2012) Perioperative closure related complication rates and cost analysis of barbed suture for closure in TKA. Clin Orthop Relat Res 470:125–129

    Article  Google Scholar 

  26. Lee SW, Nomura E, Tokuhara T et al (2011) Laparoscopic technique and initial experience with knotless, unidirectional barbed suture closure for stapleconserving, delta-shaped gastroduodenostomy after distal gastrectomy. J Am Coll Surg 213:39–45

    Article  Google Scholar 

  27. De Blasi V, Facy O, Goergen M et al (2013) Barbed versus usual suture for closure of the gastrojejunal anastomosis in laparoscopic gastric bypass: a comparative trial. Obes Surg 23:60–63

    Article  Google Scholar 

  28. Bruce J, Krukowski ZH, Al-Khairy G (2001) Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 88:1157–1168

    Article  CAS  Google Scholar 

  29. 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(9):756–759

    Article  Google Scholar 

  30. Scatizzi M, Kröning KC, Boddi V et al (2009) Fast Track Surgery after laparoscopic colorectal surgery: is it feasible in a General Surgery Unit? Surgery 147(2):219–226

    Article  Google Scholar 

  31. Sierzega M, Kolodziejczyk P, Kulig J, Polish Gastric Cancer Study Group (2010) Impact of anastomotic leakage on long-term survival after total gastrectomy for carcinoma of the stomach. Br J Surg 97:1035–1042

    Article  CAS  Google Scholar 

  32. Jarry J, Wagner T, de Pommerol M (2012) Laparoscopic Roux-en-Y gastric bypass: comparison between hand-sewn and mechanical gastrojejunostomy. Updates Surg 64:25–30

    Article  Google Scholar 

  33. Ruiz de Adana JC, Hernandez Matias A, Hernandez Bartolome M (2009) Risk of gastrojejunal anastomotic stricture with multifilament and monofilament sutures after hand-sewn laparoscopic gastric bypass: a prospective cohort study. Obes Surg 19:1274–1277

    Article  Google Scholar 

  34. Demyttenaere SV, Nau P, Henn M et al (2009) Barbed suture for gastrointestinal closure: a randomized control trial. Surg Innov 16(3):237–242

    Article  Google Scholar 

  35. Shikanov S, Wille M, Large M (2009) Knotless closure of the collecting system and renal parenchyma with a novel barbed suture during laparoscopic porcine partial nephrectomy. J Endourol 23:1157–1160

    Article  Google Scholar 

  36. Facy O, De Blasi V, Goergen M et al (2013) Laparoscopic gastrointestinal anastomoses using knotless barbed sutures are safe and reproducible: a single-center experience with 201 patients. Surg Endosc 27(10):3841–3845

    Article  Google Scholar 

  37. Bautista T, Shabbir A, Rao J et al (2015) Enterotomy closure using knotless and barbed suture in laparoscopic upper gastrointestinal surgeries. Surg Endosc 30(4):1699–1703

    Article  Google Scholar 

  38. Palmisano S, Giuricin M, Makovac P et al (2014) Totally hand-sewn anastomosis using barbed suture device during laparoscopic gastric bypass in obese. A feasibility study and preliminary results. Int J Surg 12(12):1385–1389

    Article  Google Scholar 

  39. Kassir R, Blanc P, Breton C et al (2015) Laparoscopic Roux-en-Y gastric bypass with the absorbable bidirectional monofilament barbed suture Stratafix®: the hand-sewn technique. Obes Surg 25(2):325–326

    Article  Google Scholar 

  40. Wilhelm P, Storz P, Axt S et al (2014) Use of self-retaining barbed suture for rectal wall closure in transanal endoscopic microsurgery. Tech Coloproctol 18(9):813–816

    Article  CAS  Google Scholar 

  41. Costantino F, Dente M, Perrin P et al (2013) Barbed unidirectional V-Loc 180 suture in laparoscopic Roux-en-Y gastric bypass: a study comparing unidirectional barbed monofilament and multifilament absorbable suture. SurgEndosc 27(10):3846–3851

    Google Scholar 

  42. Nemecek E, Negrin L, Beran C et al (2013) The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study. Surg Endosc 27(10):3830–3834

    Article  Google Scholar 

  43. Tyner RP, Clifton GT, Fenton SJ (2013) Hand-sewn gastrojejunostomy using knotless unidirectional barbed absorbable suture during laparoscopic gastric bypass. Surg Endosc 27(4):1360–1366

    Article  Google Scholar 

  44. Omotosho P, Yurcisin B, Ceppa E et al (2011) In vivo assessment of an absorbable and nonabsorbable knotless barbed suture for laparoscopic single-layer enterotomy closure: a clinical and biomechanical comparison against nonbarbed suture. J Laparoendosc Adv Surg Tech A 21(10):893–897

    Article  Google Scholar 

  45. Segura-Sampedro JJ, Ashrafian H, Navarro-Sánchez A et al (2015) Small bowel obstruction due to laparoscopic barbed sutures: an unknown complication? Rev Esp Enferm Dig 107(11):677–680. https://doi.org/10.17235/reed.2015.3863/2015

    Article  PubMed  Google Scholar 

  46. Vasudevan SP, Dworkin MJ (2013) Small bowel obstruction following laparoscopic ventral mesh rectopexy. Colorectal Dis 15:1543–1544

    Article  CAS  Google Scholar 

  47. Bassi A, Tulandi T (2013) Evaluation of total laparoscopic hysterectomy with and without the use of barbed suture. J Obstet Gynaecol Can 35:718–722

    Article  Google Scholar 

  48. Donnellan NM, Mansuria SM (2011) Small bowel obstruction resulting from laparoscopic vaginal cuff closure with a barbed suture. J Minim Invasive Gynecol 18:528–530

    Article  Google Scholar 

  49. Moran ME, Marsh C, Perrotti M (2007) Bidirectional barbed sutured knotless running anastomosis vs classic van Velthoven in a model system. J Endourol 21:1175–1178

    Article  Google Scholar 

  50. Greenberg JA (2010) The use of barbed sutures in obstetrics and gynecology. Rev Obstet Gynecol 3:82–91

    PubMed  PubMed Central  Google Scholar 

  51. Weld KJ, Ames CD, Hruby G (2006) Evaluation of a novel knotless self-anchoring suture material for urinary tract reconstruction. Urology 67:1133–1137

    Article  Google Scholar 

  52. Einarsson JI, Vellinga TT, Twijnstra AR (2010) Bidirectional barbed suture: an evaluation of safety and clinical outcomes. JSLS 14:381–385

    Article  Google Scholar 

  53. Spah CE, Elkins AD, Wehrenberg A et al (2013) Evaluation of two novel self-anchoring barbed sutures in a prophylactic laparoscopic gastropexy compared with intracorporeal tied knots. Vet Surg 42(8):932–942

    Article  Google Scholar 

  54. Kim JC, Lee YK, Lm BS (2007) Comparison of tensile and knot security properties of surgical sutures. J Mater Sci Mater Med 12:2363–2369

    Article  Google Scholar 

  55. Tera H, Aberg C (1977) Strength of knots in surgery in relation to type of knot, type of suture material and dimension of the suture thread. Acta Chir Scand 143:75–83

    CAS  PubMed  Google Scholar 

  56. Arbaugh M, Case B, Monnet E (2013) Biomechanical comparison of Glycomer 631 and Glycomer 631 knotless for use in canine incisional gastropexy. Vet Surg 42:205–209

    Article  Google Scholar 

  57. Milone M, Elmore U, Di Salvo E et al (2015) Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers. Surg Endosc 29(8):2314–2320

    Article  Google Scholar 

  58. Lee KH, Ho J, Akmal Y et al (2013) Short- and long-term outcomes of intracorporeal versus extracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy for colon cancer. Surg Endosc 27(6):1986–1990

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General and Oncologic Surgery, Santo Stefano Hospital, Via Suor Niccolina 20, 59100, Prato, PO, Italy

    Francesco Feroci, Iacopo Giani, Maddalena Baraghini, Luca Romoli, Tiku Zalla, Roberto Quattromani, Stefano Cantafio & Marco Scatizzi

Authors
  1. Francesco Feroci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Iacopo Giani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maddalena Baraghini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luca Romoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tiku Zalla
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roberto Quattromani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stefano Cantafio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marco Scatizzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Feroci.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures in our paper were in accordance with the ethical standards of the institutional as well as national research committee and with the 1964 Helsinki declaration and its later amendments.

Research involving human participants and/or animals

This articles does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

No informed consent is required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Feroci, F., Giani, I., Baraghini, M. et al. Barbed versus traditional suture for enterotomy closure after laparoscopic right colectomy with intracorporeal mechanical anastomosis: a case–control study. Updates Surg 70, 433–439 (2018). https://doi.org/10.1007/s13304-017-0502-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-017-0502-4

Keywords

Search

Navigation