title: Use of Barbed Sutures in Laparoscopic Gastrointestinal Single-Layer Sutures.
abstract: OBJECTIVE
  Laparoscopic anastomotic methods are not commonly used because of the cumbersome laparoscopic intracorporeal sutures and tying involved. The barbed suture is one of the various devices developed to simplify the placement of intracorporeal sutures. However, barbed sutures are not commonly used during reconstruction after radical gastrectomy in cancer patients or for single-layer entire-thickness running suturing for intestinal anastomoses. We describe the procedure for using barbed sutures and report on the short-term surgical outcomes.
  
  
  METHODS
  Between August 2012 and March 2014, 15-cm-long barbed sutures (V-Loc 180; Covidien, Mansfield, MA, USA) were used for laparoscopic intestinal anastomoses, including intestinal hole closure for esophagojejunal and gastrojejunal anastomoses after mechanical anastomoses and gastric wall closure after partial resection.
  
  
  RESULTS
  In total, 38 patients underwent 40 laparoscopic anastomoses (esophagojejunostomies, 26; gastrojejunostomies, 7; and simple closure of gastric defect, 7); no cases required conversion to open surgery. Two cases exhibited positive air leak test results during surgery (1 case of esophagojejunostomy and 1 case of simple closure of gastric defect). Two cases of intestinal obstruction were noted; of those, one patient with postoperative intestinal paresis (grade II) was managed conservatively, and the other underwent repeat laparoscopic surgery (grade IIIb) for internal herniation unrelated to V-Loc use. No postoperative complications at the anastomosis site and no surgery-related deaths were noted.
  
  
  CONCLUSIONS
  Single-layer entire-thickness running suturing with the V-Loc 180 barbed suture after stapled side-to-side intestinal anastomosis was found to be safe and feasible in the reported cases.
authors: Department of Surgery, Toyama Prefectural Central Hospital, Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
authors: Tomoya
authors: T
authors: Tsukada
authors: Department of Surgery, Toyama Prefectural Central Hospital, Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
authors: Masahide
authors: M
authors: Kaji
authors: Department of Gastroenterologic Surgery, Kanazawa University, Department of Gastroenterologic Surgery, Kanazawa University, Ishikawa, Japan.
authors: Jun
authors: J
authors: Kinoshita
authors: Department of Surgery, Toyama Prefectural Central Hospital, Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
authors: Koichi
authors: K
authors: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation* / Q000379:methods; D015390:Gastric Bypass / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome
keywords: Laparoscopic surgery; Surgical Anastomosis; Suture Techniques