title: Laparoscopic technique and safety experience with barbed suture closure for pelvic cavity after abdominoperineal resection.
abstract: BACKGROUND
  Between April 2005 and December 2012, we performed laparoscopic colorectal resection with regional lymph node dissection on 273 cases of colorectal cancer patients. However, Laparoscopic rectal cancer surgery requires a high degree of skill. Any surgeon who is going to embark on these difficult resections should have at a minimum laparoscopic suturing skills in order to be able to close the peritoneal defect.
  
  
  METHODS
  In laparoscopic surgery for rectal cancer, the intracorporeal suture technique required to close the pelvic cavity is very difficult. Barbed sutures have recently been proposed to facilitate laparoscopic suturing. Two patients with rectal cancer who underwent laparoscopic abdominoperineal resection (APR) with intracorporeal closure of the pelvic cavity from September to October 2012 were enrolled in this study.
  
  
  RESULTS
  We present our initial experience of two consecutive cases of intracorporeal closure of the pelvic cavity by totally laparoscopic APR. After clinical follow-up, the two patients have no complaints and have shown no signs of recurrence.
  
  
  CONCLUSIONS
  We hypothesized that barbed sutures could potentially improve the efficiency of intracorporeal closure of the pelvic cavity after laparoscopic APR. Further, we expect that use of the V-Loc™ will reduce intra-operative stress on the endoscopic surgeon.
authors.affiliation: Surgical Oncology, Gifu University School of Medicine, 1-1 Yanagido, Gifu City 501-1194, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Matsuhashi
authors.forename: Takao
authors.initials: T
authors.lastname: Takahashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nonaka
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tanahashi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Imai
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Osada
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010388:Pelvis / Q000601:surgery*; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012004:Rectal Neoplasms / Q000601:surgery*; D013536:Suture Techniques; D013537:Sutures