Laparoscopic Barbed Stitching Application In Gynecology

Introduction: Laparoscopic stitching is considered to be one of the most difficult and long procedures in laparoscopy. Our team started to use a bidirectional barbed stitch for vaginal closure, after uterus removal and for uterus closure, after myoma resection. For the first time we used it in March 2008 and we applied it in more than 100 cases with a good result. Methods: This stitch is chracterized by a presence of little barbs and a needle on both ends. The position of the barbs (other than a needle direction), provides only a one-way movement of the suture and gives the proper tension of the skin. What is more, thanks to the fact that barbs are in the opposite direction, no knot is required. Barb suture found its application in myoma resection, while it prevents excessive tension of the wound. Results: Application of the barb suturing provides a safe closure and makes the laparoscopic stitching more applicable for beginners. Conclusion: This is a presentation of how to apply barb suturing for vaginal and uterus closure. Authors: Jon Ivar Einarsson, MD, MPH, James A. Greenberg, MD