title: Evaluation of total laparoscopic hysterectomy with and without the use of barbed suture.
abstract: OBJECTIVE
  To evaluate the outcome of total laparoscopic hysterectomy with and without the use of barbed suture.
  
  
  METHODS
  We conducted a retrospective study among patients who underwent total laparoscopic hysterectomy between February 2008 and August 2012. The parameters evaluated were age, BMI, operative time, hospital stay, pre- and postoperative hemoglobin levels, uterine weight, intraoperative blood loss, and postoperative complications.
  
  
  RESULTS
  A total of 202 women underwent total laparoscopic hysterectomy; barbed suture (V-Loc) was used in 63 women, and polydioxanone (PDS) in 139. Estimated blood loss, difference in hemoglobin level before and after surgery, operative time, and the duration of hospital stay were comparable between the two groups of patients. The incidence of postoperative fever was higher in the V-Loc group than in the PDS group (P = 0.003). Multiple linear regression analysis showed that the incidence of postoperative fever was related to BMI (P = 0.02, r = 0.22) and estimated blood loss (P = 0.004, r = 0.28) and not to age, operative time, or uterine weight.
  
  
  CONCLUSIONS
  The use of barbed suture to close the vaginal vault after laparoscopic hysterectomy, compared with standard suture, results in similar operative time, blood loss, and duration of hospital stay. The use of barbed suture is technically less demanding than the use of regular sutures.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal QC.
authors.forename: Ali
authors.initials: A
authors.lastname: Bassi
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal QC.
authors.forename: Togas
authors.initials: T
authors.lastname: Tulandi
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001810:Blood Volume; D002170:Canada; D057186:Comparative Effectiveness Research; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D009929:Organ Size; D016687:Polydioxanone; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D013536:Suture Techniques / Q000592:standards*; D014599:Uterus / Q000473:pathology* / Q000601:surgery; D014621:Vagina / Q000601:surgery*
chemical_list: D016687:Polydioxanone
keywords: V-Loc suture; barbed suture; laparoscopic hysterectomy; vaginal vault