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Laparoscopic gastrointestinal anastomoses using knotless barbed sutures are safe and reproducible: a single-center experience with 201 patients

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Abstract

Background

Intestinal anastomosis is a complex procedure during laparoscopy, mainly due to the difficulties knotting the sutures. Unidirectional barbed sutures have been proposed to simplify wall and mesentery closure, but the results for intestinal anastomosis are not clear. This study aimed to establish the feasibility and the safety of laparoscopic intestinal anastomosis using barbed suture.

Methods

Between June 2011 and May 2012, 15-cm-long unidirectional absorbable barbed sutures (V-Loc; Covidien, Mansfield, MA, USA) were used for all laparoscopic intestinal anastomoses: one suture for closure of intestinal openings after mechanical anastomoses and two sutures for hand-sewn anastomoses.

Results

Over a 1-year period, 201 consecutive patients required 220 laparoscopic anastomoses for gastrojejunostomy (n = 177; 172 during Roux-en-Y gastric bypass and 5 after gastrectomy), ileocolostomy (n = 15), colocolostomy (n = 1), esophagojejunostomy (n = 5), and jejunojejunostomy (n = 22; 4 after small bowel resection and 18 during gastric bypass or gastrectomy). Senior and training surgeons performed 209 closures of intestinal openings and 11 hand-sewn anastomoses. There was no conversion to usual sutures. One fistula occurred in an esophagojejunostomy and was managed conservatively. One self-limited anastomotic bleeding occurred, and no anastomotic stenosis occurred during 6 months of follow-up evaluation.

Conclusions

The use of knotless barbed suture for laparoscopic intestinal anastomosis is safe and reproducible.

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Disclosure

Olivier Facy, Vito De Blasi, Martine Goergen, Luca Arru, Luigi De Magistris, and Juan-Santiago Azagra have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Digestive Surgery, University Hospital of Luxembourg, Luxembourg, Luxembourg

    Olivier Facy, Vito De Blasi, Martine Goergen, Luca Arru, Luigi De Magistris & Juan-Santiago Azagra

  2. Unité des Maladies de l’Appareil Digestif et Endocrine (UMADE), Centre Hospitalier de Luxembourg, 4 rue Barblé, 1210, Luxembourg City, Luxembourg

    Olivier Facy & Juan-Santiago Azagra

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  1. Olivier Facy
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  2. Vito De Blasi
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  3. Martine Goergen
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  4. Luca Arru
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  5. Luigi De Magistris
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  6. Juan-Santiago Azagra
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Correspondence to Olivier Facy or Juan-Santiago Azagra.

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Facy, O., De Blasi, V., Goergen, M. et al. Laparoscopic gastrointestinal anastomoses using knotless barbed sutures are safe and reproducible: a single-center experience with 201 patients. Surg Endosc 27, 3841–3845 (2013). https://doi.org/10.1007/s00464-013-2992-6

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  • DOI: https://doi.org/10.1007/s00464-013-2992-6

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