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Barbed Suture for Gastrointestinal Closure: A Randomized Control Trial

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Peter Nau, MD

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Matthew Henn, MD

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Catherine Beck, MD

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Jeffrey Zaruby, DVM, PhD, DACVS

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Michael Primavera, BS

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

David Kirsch, MS

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Jeffrey Miller, MS

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

James J. Liu, MD

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

Andrew Bellizzi, MD

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus

W. Scott Melvin, MD

Department of Surgery, Center for Minimally Invasive Surgery, Ohio State University Medical Center, Columbus, scott.melvin{at}osumc.edu

In an effort to make laparoscopic suturing more efficient, the V-Loc advanced wound closure device (Covidien, Mansfield, MA) has been produced. This device is a self-anchoring barbed suture that obviates the need for knot tying. The goal of this initial feasibility study was to investigate the use of the barbed suture in gastrointestinal enterotomy closure. A randomized study of 12 pigs comparing enterotomy closure with barbed versus a nonbarbed suture of similar tensile strength was performed. To this end, 25 mm enterotomies were made in the stomach (1 control, 1 treatment), jejunum (2 controls, 2 treatments), and descending colon (1 control, 1 treatment). Animals were killed at 3, 7, and 14 days postoperatively (4 each group) and their gastrointestinal tracts harvested; 6 of the 8 enterotomies from each pig underwent burst strength testing. The remaining 2 were fixed in formalin and sent for histological examination. All 12 pigs survived until they were killed without any major complications. Enterotomy closure with barbed suture revealed adhesion scores, burst strength pressures, and histology scores that were similar to those for the control. Jejunal closures resulted in 6 failures at 7 days (3 control, 3 barbed) and 4 failures at 14 days (2 control, 2 barbed). The barbed suture significantly reduced suturing time in the stomach, jejunum, and colon. The V-Loc wound closure device appears to offer comparable gastrointestinal closure to 3-0 Maxon while being significantly faster. Further studies with V-Loc are required to assess its use in laparoscopic surgery.

Key Words: barbed suture • gastrointestinal anastomosis • laparoscopy • enterotomy • burst strength testing • adhesion

Surgical Innovation, Vol. 16, No. 3, 237-242 (2009)
DOI: 10.1177/1553350609342988


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