Unidirectional barbed suture for vaginal cuff closure without backward stitch in total laparoscopic hysterectomy.
AIM
To evaluate the safety and efficacy of unidirectional barbed suture technique for vaginal cuff closure in total laparoscopic hysterectomy (TLH).


METHODS
In a retrospective chart review, data were analyzed from 165 patients who underwent a TLH with an unidirectional barbed suture technique for vaginal cuff closure from January 2012 to June 2016 at tertiary-care university-based teaching hospital and academic affiliated hospital. Vaginal cuff was closed by single layer 3/0 V-Loc unidirectional 9″, 180 day Absorbable Wound Closure Device (Covidien Healthcare, Mansfield, MA) and the suture was not stitched backward to secure distal end.


RESULTS
A total of 165 patients were included and the median age was 50 years (range, 35-84 years). The median completion time for hysterectomy time was 100 min (range, 40-240 min) and the median vaginal cuff closure time was 7 min (range, 4-15 min). The median estimated blood loss was 87.8 mL (range 30-250 mL) and the median uterine weight was 200 g (range, 40-900 g). Intraoperative complication included bladder perforation (1.2%) and postoperative complications were vaginal cuff dehiscence (1.8%), cuff cellulitis (0.6%), vesicovaginal fistula (0.6%) and unexplained fever (0.6%).


CONCLUSION
According to the results of current study, the use of unidirectional barbed suture without backward stitching appears to be safe for the vaginal cuff closure in TLH.
['Misirlioglu|Selim|S|http://orcid.org/0000-0002-5390-6637', 'Boza|Aysen|A|', 'Arslan|Tonguc|T|', 'Urman|Bulent|B|', 'Taskiran|Cagatay|C|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D006801:Humans D007044:Hysterectomy D010535:Laparoscopy D008875:Middle Aged D061646:Operative Time D012189:Retrospective Studies D013536:Suture Techniques D014621:Vagina
unidirectional barbed suture cuff closure total laparoscopic hysterectomy without stitch technique