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                                        Barbed Sutures in Laparoscopic Myomectomy—Realistic Expectations: A Critical Review

             None of the other studies specifically looked at a fall in  REFERENCES
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                                                                  barbed suture vs continuous suture with intracorporeal knots in
             None of the other studies specifically compared the  laparoscopic myomectomy: a randomized study. Journal of
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          2011 the mean (SD) adhesion score was not significantly
                                                                  Oronzi I, Luvero D, Scaletta G, Muzii L, Panici PB. A new
          different between the barbed suture group [3.78 (3.92)] vs  type of absorbable barbed suture for use in laparoscopic
          the Vicryl group [3.04 (3.75)]. 11                      myomectomy. Int J Gynecol Obstet 2012 June;117(3):220-223.
             None of the other studies specifically compared the  7. Einarsson JI, Vellinga TT, Twijnstra AR, Chavan NR,
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                                                               8. Paul MD. Bidirectional barbed sutures for wound closure:
          CONCLUSION                                              evolution and applications. J American College of Certified
                                                                  Wound Specialists 2009 April;1(2):51-57.
          A laparoscopic approach to myomectomy may be safely  9. Greenberg JA. The use of barbed sutures in obstetrics and
          chosen for patients to be proposed for surgical treatment of  gynecology. Rev Obstet Gynecol 2010 Summer;3(3):82-91.
          subserous and intramural myomata of average size and few  10. Greenberg JA, Clark RM. Advances in suture material for
                                                                  obstetric and gynecologic surgery. Rev Obstet Gynecol 2009
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                                                                  Summer;2(3):146-158.
          reduce the myoma bed suturing time as well as the mean  11. Einarrson JI, Vonnahme KA, Sandberg EM, Grazul Bilska AT.
          operation time, when compared to the conventional       Barbed compared with standard suture: effects on cellular
          intracorporeal suturing with knotting. Intracorporeal   composition and proliferation of the healing wound in the ovine
                                                                  uterus. Fertility and Sterility 2011 June;95(7):2426-2428.
          suturing with barbed sutures was also seen to reduce the
                                                              12. Einarsson JI, Grazul-Bilska AT, Vonnahme KA. Barbed vs
          intraoperative blood loss and fall in hemoglobin levels when  standard suture: randomized single-blinded comparison of
          compared to the conventional suturing. Myomectomy scars  adhesion formation and ease of use in an animal model. Journal
          after laparoscopy is a debatable issue but the studies  of Minimally Invasive Gynecology 2011 Nov-Dec ;18(6):716-719.
          reviewed here seems to present a picture of comparable
          healing rates and strength when compared to conventional  ABOUT THE AUTHOR
          suturing. Further studies with longer follow-up would be
                                                              Shyjus Puliyathinkal
          needed to present a clearer picture on scar integrity with
                                                              Assistant Professor, Department of Obstetrics and Gynecology, MES
          use of barbed sutures. Most importantly, the use of barbed
                                                              Medical College, Perinthalmanna, Kerala, India
          sutures can help to popularize laparoscopic myomectomy
                                                              Correspondence Address: 315, Sana Apartments, Puthanangadi
          even among those surgeons who have been unable to master  Malappuram, Kerala, India, Phone: +91-9747355709, +91-4933253305
          laparoscopic knotting skills.                       e-mail: shyjusnair7479@gmail.com














          World Journal of Laparoscopic Surgery, September-December 2013;6(3):167-169                      169
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