Barbed Suture Vs Polyglactin 910 Suture in Total Laparoscopi
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Laparoscopic suturing of the vaginal cuff and knotting is the most challenging step in total laparoscopic hysterectomy (TLH) and requires surgical skill. The study suggests that unidirectional barbed suture effectively decreases vaginal cuff closure time.

The objective of this study was to compare the efficacy and safety of unidirectional barbed suture with the conventional polyglactin 910 suture for vaginal cuff closure in patients with benign uterine diseases undergoing total laparoscopic hysterectomy.

A prospective observational study was carried out for two years. A total of 109 patients with benign uterine diseases planned for TLH were included in the study. Laparoscopic vaginal cuff closure was performed with the unidirectional barbed suture (V-Loc) in 44 patients and with the standard polyglactin 910 suture (Vicryl) in 65 patients.

The primary outcome measure was vaginal cuff closure time. Secondary outcome measures included total operative time, blood loss, the average number of stitches, postoperative pain perception, duration of hospital stay, vaginal cuff-related complications, and dyspareunia.

--The mean vaginal cuff closure time was significantly less in the V-Loc group than in the Vicryl group.

--Mean operative time was comparable in both groups.

--Other intraoperative parameters, such as blood loss and number of stitches in cuff closure, and postoperative characteristics, such as pain score, duration of hospital stay, vaginal cuff-related complications, and dyspareunia, were comparable in both the groups.

Conclusively, the unidirectional barbed suture significantly reduces vaginal cuff closure time. It is a safe, effective, and well-tolerated alternative to conventional Vicryl suture for vaginal cuff closure in TLH without increasing the risk of postoperative vaginal complications particularly where affordability is not an issue and resources are accessible.

Cureus
Source: https://www.cureus.com/articles/54317-unidirectional-barbed-suture-versus-polyglactin-910-suture-for-vaginal-cuff-closure-in-total-laparoscopic-hysterectomy
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