熊切 順
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Long unidirectional barbed suturing technique with extracorporeal traction in laparoscopic myomectomy.
Journal Formal name:BMC surgery
Abbreviation:BMC Surg
ISSN code:14712482/14712482
Domestic / ForeginForegin
Volume, Issue, Page 14,pp.84
Author and coauthor Aoki Yoichi, Kikuchi Iwaho, Kumakiri Jun, Kitade Mari, Shinjo Azusa, Ozaki Rie, Kawasaki Yu, Takeda Satoru
Publication date 2014/10
Summary BACKGROUND:Myomectomy is now often performed laparoscopically rather than by laparotomy to alleviate the risk of postoperative adhesions and reduce postoperative pain. However, intracorporeal knot-tying under direct laparoscopy is difficult and requires proficiency. We conducted a retrospective study comparing the results of a long unidirectional barbed suturing technique (with V-Loc180 suture) and the results of conventional suturing as applied to laparoscopic myomectomy.METHODS:In women who underwent laparoscopic myomectomy in our university hospital between January 2011 and April 2013, uninterrupted suturing of 2 or more layers was performed. These women were divided into 2 groups according to the method of suturing: those in whom standard absorbable sutures were used (group P, n =42) and those in whom our suturing technique was used (group V, n =41). Patient characteristics and surgical variables were compared between the 2 groups.RESULTS:No significant between-group difference was observed in age (p = .975), body mass index (p = .778), GnRHa administration (p = .059), intraoperative vasopressin dose (p = .364), intraoperative blood loss (73.8 ± 64.1 vs. 59.3 ± 54.0 mL, respectively; p = .199), myoma mass (212.6 ± 133.3 vs. 208.3 ± 198.4 g, respectively; p = .134), ΔHb (p = .517), or postoperative hospital stay (p = .314). Operation time (mean ± SD) was significantly shorter for group V (71.2 ± 22.9 minutes; range, 28.0-110.0 minutes; p < .001) than for group P (94.4 ± 27.2 minutes; range, 53.0-165.0 minutes). No patient required intraoperative transfusion or conversion to laparotomy.CONCLUSIONS:Our suturing technique exploits the features of unidirectional barbed sutures and can be used in the same way as the conventional method when performing continuous suturing for laparoscopic myomectomy. Our data suggest that operation time can be reduced by as much as 25% with this new technique.
DOI 10.1186/1471-2482-14-84
PMID 25345546