TY - JOUR
T1 - Barbed suture for gastrointestinal closure
T2 - A randomized control trial
AU - Demyttenaere, Sebastian V.
AU - Nau, Peter
AU - Henn, Matthew
AU - Beck, Catherine
AU - Zaruby, Jeffrey
AU - Primavera, Michael
AU - Kirsch, David
AU - Miller, Jeffrey
AU - Liu, James J.
AU - Bellizzi, Andrew
AU - Melvin, W. Scott
PY - 2009
Y1 - 2009
N2 - In an effort to make laparoscopic suturing more efficient, the V-Loc advanced wound closure device (Covidien, Mansfield, MA) has been produced. This device is a self-anchoring barbed suture that obviates the need for knot tying. The goal of this initial feasibility study was to investigate the use of the barbed suture in gastrointestinal enterotomy closure. A randomized study of 12 pigs comparing enterotomy closure with barbed versus a nonbarbed suture of similar tensile strength was performed. To this end, 25 mm enterotomies were made in the stomach (1 control, 1 treatment), jejunum (2 controls, 2 treatments), and descending colon (1 control, 1 treatment). Animals were killed at 3, 7, and 14 days postoperatively (4 each group) and their gastrointestinal tracts harvested; 6 of the 8 enterotomies from each pig underwent burst strength testing. The remaining 2 were fixed in formalin and sent for histological examination. All 12 pigs survived until they were killed without any major complications. Enterotomy closure with barbed suture revealed adhesion scores, burst strength pressures, and histology scores that were similar to those for the control. Jejunal closures resulted in 6 failures at 7 days (3 control, 3 barbed) and 4 failures at 14 days (2 control, 2 barbed). The barbed suture significantly reduced suturing time in the stomach, jejunum, and colon. The V-Loc wound closure device appears to offer comparable gastrointestinal closure to 3-0 Maxon while being significantly faster. Further studies with V-Loc are required to assess its use in laparoscopic surgery.
AB - In an effort to make laparoscopic suturing more efficient, the V-Loc advanced wound closure device (Covidien, Mansfield, MA) has been produced. This device is a self-anchoring barbed suture that obviates the need for knot tying. The goal of this initial feasibility study was to investigate the use of the barbed suture in gastrointestinal enterotomy closure. A randomized study of 12 pigs comparing enterotomy closure with barbed versus a nonbarbed suture of similar tensile strength was performed. To this end, 25 mm enterotomies were made in the stomach (1 control, 1 treatment), jejunum (2 controls, 2 treatments), and descending colon (1 control, 1 treatment). Animals were killed at 3, 7, and 14 days postoperatively (4 each group) and their gastrointestinal tracts harvested; 6 of the 8 enterotomies from each pig underwent burst strength testing. The remaining 2 were fixed in formalin and sent for histological examination. All 12 pigs survived until they were killed without any major complications. Enterotomy closure with barbed suture revealed adhesion scores, burst strength pressures, and histology scores that were similar to those for the control. Jejunal closures resulted in 6 failures at 7 days (3 control, 3 barbed) and 4 failures at 14 days (2 control, 2 barbed). The barbed suture significantly reduced suturing time in the stomach, jejunum, and colon. The V-Loc wound closure device appears to offer comparable gastrointestinal closure to 3-0 Maxon while being significantly faster. Further studies with V-Loc are required to assess its use in laparoscopic surgery.
KW - Adhesion
KW - Barbed suture
KW - Burst strength testing
KW - Enterotomy
KW - Gastrointestinal anastomosis
KW - Laparoscopy
UR - http://www.scopus.com/inward/record.url?scp=70349592829&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349592829&partnerID=8YFLogxK
U2 - 10.1177/1553350609342988
DO - 10.1177/1553350609342988
M3 - Article
C2 - 19783567
AN - SCOPUS:70349592829
SN - 1553-3506
VL - 16
SP - 237
EP - 242
JO - Surgical Innovation
JF - Surgical Innovation
IS - 3
ER -