title: Barbed versus standard suture: a randomized trial for laparoscopic vaginal cuff closure.
abstract: OBJECTIVE
  To compare closure times, cuff healing, and postoperative dyspareunia between barbed and traditional sutures during laparoscopic total hysterectomy.
  
  
  METHODS
  A randomized clinical trial (Canadian Task Force classification I).
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Sixty-three women undergoing total laparoscopic hysterectomy.
  
  
  METHODS
  Total laparoscopic hysterectomy was performed using standard techniques. The vaginal cuff closure method was randomized to barbed suture (Quill; Angiotech Pharmaceuticals, Inc., Vancouver, Canada) or standard suture (Vicryl; Ethicon Inc., Somerville, NJ). The time required for cuff closure was documented. Patients were examined postoperatively to assess cuff healing, and a standardized sexual function questionnaire was administered preoperatively and at 3 months postoperatively.
  
  
  RESULTS
  The mean vaginal cuff closure time was 10.4 minutes versus 9.6 minutes in the barbed versus standard suture group (p = .51). Cuff healing appeared similar between the 2 groups. Rates of dyspareunia, partner dyspareunia, and sexual function were similar in both groups at 3 months postoperatively. Vaginal cuff closure times were significantly faster among attendings compared with residents/fellows (7.1 vs. 12.8 minutes, respectively; p < .0001). The study was designed to have a statistical power of 80% to detect a difference of 5 minutes in cuff closure time between the 2 groups (α level of 0.05).
  
  
  CONCLUSIONS
  Laparoscopic vaginal cuff closure times are similar when using barbed sutures and braided sutures.
authors.affiliation: Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. jeinarsson@partners.org.
authors.forename: Jon I
authors.initials: JI
authors.lastname: Einarsson
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Cohen
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Gobern
authors.forename: Evelien M
authors.initials: EM
authors.lastname: Sandberg
authors.forename: Catherine I
authors.initials: CI
authors.lastname: Hill-Lydecker
authors.forename: Karen
authors.initials: K
authors.lastname: Wang
authors.forename: Douglas N
authors.initials: DN
authors.lastname: Brown
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*
keywords: Barbed suture; Laparoscopy; Total hysterectomy; Vaginal cuff