title: Use of self-retaining barbed suture for rectal wall closure in transanal endoscopic microsurgery.
abstract: BACKGROUND
  The aim of this study was to investigate the safety and efficacy of self-retaining barbed sutures in comparison with monofilament clip-fixated sutures for rectal wall closure in transanal endoscopic microsurgery.
  
  
  METHODS
  Horizontal full-thickness wall defects (3.5 cm) of cattle rectal specimens were closed via transanal endoscopic microsurgery using a monofilament suture with clips at the end (Surgipro(®) 2/0; Covidien, Mansfield, MA, USA, n = 25) or a self-retaining barbed suture (V-Loc™ 180 3/0; Covidien, Mansfield, MA, USA, n = 25). The primary endpoint was the pneumatic leakage pressure of the suture line. As a secondary endpoint, suture time was evaluated.
  
  
  RESULTS
  The median pneumatic leakage pressure for barbed sutures was 45.5 mbar (range 17-106 mbar) and 33.5 mbar (range 19-106 mbar) for monofilament sutures (p = 0.58). A pneumatic leak at a critical pressure below 25 mbar occurred in 3 cases with barbed sutures and in 7 cases with monofilament sutures (p = 0.29). Median suturing time [19:25 min:s (range 12:00-33:30) vs. 20:41 (17:00-28:33), p = 0.23] did not differ between the two groups.
  
  
  CONCLUSIONS
  Barbed sutures display the same bursting pressure as monofilament sutures and their use for rectal wall closure seems feasible.
authors.affiliation: Working Group for Surgical Technology and Training, Clinic for General, Visceral and Transplant Surgery, Tübingen University Hospital, Waldhörnlestrasse 22, 72072, Tübingen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Wilhelm
authors.forename: P
authors.initials: P
authors.lastname: Storz
authors.forename: S
authors.initials: S
authors.lastname: Axt
authors.forename: C
authors.initials: C
authors.lastname: Falch
authors.forename: A
authors.initials: A
authors.lastname: Kirschniak
authors.forename: S
authors.initials: S
authors.lastname: Muller
mesh_terms: D001003:Anal Canal; D057868:Anastomotic Leak; D000818:Animals; D002417:Cattle; D016099:Endoscopy, Gastrointestinal; D004867:Equipment Design; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D011312:Pressure; D012007:Rectum / Q000601:surgery*; D013537:Sutures / Q000009:adverse effects; D013997:Time Factors; D058106:Wound Closure Techniques / Q000009:adverse effects