title: Long unidirectional barbed suturing technique with extracorporeal traction in laparoscopic myomectomy.
abstract: BACKGROUND
  Myomectomy is now often performed laparoscopically rather than by laparotomy to alleviate the risk of postoperative adhesions and reduce postoperative pain. However, intracorporeal knot-tying under direct laparoscopy is difficult and requires proficiency. We conducted a retrospective study comparing the results of a long unidirectional barbed suturing technique (with V-Loc180 suture) and the results of conventional suturing as applied to laparoscopic myomectomy.
  
  
  METHODS
  In women who underwent laparoscopic myomectomy in our university hospital between January 2011 and April 2013, uninterrupted suturing of 2 or more layers was performed. These women were divided into 2 groups according to the method of suturing: those in whom standard absorbable sutures were used (group P, n =42) and those in whom our suturing technique was used (group V, n =41). Patient characteristics and surgical variables were compared between the 2 groups.
  
  
  RESULTS
  No significant between-group difference was observed in age (p = .975), body mass index (p = .778), GnRHa administration (p = .059), intraoperative vasopressin dose (p = .364), intraoperative blood loss (73.8 ± 64.1 vs. 59.3 ± 54.0 mL, respectively; p = .199), myoma mass (212.6 ± 133.3 vs. 208.3 ± 198.4 g, respectively; p = .134), ΔHb (p = .517), or postoperative hospital stay (p = .314). Operation time (mean ± SD) was significantly shorter for group V (71.2 ± 22.9 minutes; range, 28.0-110.0 minutes; p < .001) than for group P (94.4 ± 27.2 minutes; range, 53.0-165.0 minutes). No patient required intraoperative transfusion or conversion to laparotomy.
  
  
  CONCLUSIONS
  Our suturing technique exploits the features of unidirectional barbed sutures and can be used in the same way as the conventional method when performing continuous suturing for laparoscopic myomectomy. Our data suggest that operation time can be reduced by as much as 25% with this new technique.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan. kikuchiban@hotmail.com.
authors.forename: Iwaho
authors.initials: I
authors.lastname: Kikuchi
authors.forename: Jun
authors.initials: J
authors.lastname: Kumakiri
authors.forename: Mari
authors.initials: M
authors.lastname: Kitade
authors.forename: Azusa
authors.initials: A
authors.lastname: Shinjo
authors.forename: Rie
authors.initials: R
authors.lastname: Ozaki
authors.forename: Yu
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeda
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009214:Myoma / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*