Unidirectional barbed suture versus continuous suture with intracorporeal knots in laparoscopic myomectomy: A randomized study

Study Objective: To estimate the effectiveness of unidirectional knotless barbed suture and continuous suture with intracorporeal knots in the repair of uterine wall defects during laparoscopic myomectomy. Design: Randomized clinical study (Canadian Task Force Classification I). Setting: Single-center study in a university hospital. Patients: This study enrolled 44 women who underwent laparoscopic myomectomy. Interventions: In accord with to the randomization, the uterine wall defects were closed either with a continuous suture with intracorporeal knots (group V) or a unidirectional knotless barbed suture (group L). Measurements and Main Results: The time required to suture the uterine wall defect was significantly lower in group L (11.5 ± 4.1 minutes) than in group V (17.4 ± 3.8 minutes; p<.001). However, no significant difference was observed in the operative time between the 2 study groups. The intraoperative blood loss was significantly lower in group L than in group V (p=.004). The degree of surgical difficulty was significantly lower in group L (3.7±1.1) than in group V (6.1±2.1; p<.001). Conclusion: The unidirectional knotless barbed suture may facilitate the suture of uterine wall defects during laparoscopic myomectomy. When compared with continuous suture and intracorporeal knots, the barbed suture reduces the time required to suture the uterine wall defect and the intraoperative blood loss. © 2010 AAGL.