title: Bidirectional barbed suture: an evaluation of safety and clinical outcomes.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of using bidirectional barbed suture in laparoscopic myomectomy (LM) and total laparoscopic hysterectomy (TLH).
  
  
  METHODS
  This was a case series of clinical outcomes following 172 consecutive LM and TLH cases over a 1-year period conducted at a university teaching hospital. It included 172 women (ages 17 to 81), requiring a myomectomy or hysterectomy for symptomatic uterine fibroids, pelvic pain, or abnormal uterine bleeding; 117 women underwent TLH and 55 women underwent LM. Patients were contacted over the phone 6 months after surgery to inquire about number of days of postoperative vaginal bleeding, visits to the hospital due to bleeding, dyspareunia, and other potential complications.
  
  
  RESULTS
  For TLH, the average duration of surgery was 109 minutes, average uterine weight was 256 grams (range, 18 to 1242), and average blood loss was 71 mL. In LM, average duration of surgery was 125 minutes, average weight of fibroids was 252 g, average number of fibroids removed was 4.0, and average blood loss was 159 mL. Seven percent of patients and 8% of their partners had persistent dyspareunia after surgery. There were no conversions to laparotomy.
  
  
  CONCLUSIONS
  The use of bidirectional barbed suture appears to be safe for closing the vaginal cuff in a TLH and for closing the hysterotomy site during a laparoscopic myomectomy.
authors.affiliation: Brigham and Women's Hospital, 75 Francis St, ASB 1-3, Boston, MA 02118, USA. jeinarsson@partners.org
authors.forename: Jon I
authors.initials: JI
authors.lastname: Einarsson
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Vellinga
authors.forename: Andries R
authors.initials: AR
authors.lastname: Twijnstra
authors.forename: Niraj R
authors.initials: NR
authors.lastname: Chavan
authors.forename: Yoko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: James A
authors.initials: JA
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery*; D055815:Young Adult