{"title":"Small Bowel Obstruction Following Laparoscopic Sacrocervicopexy Involving Barbed Sutures: Case Report and Focused Review.","authors":"Tsunagu Ichikawa, Edward Marici","doi":"10.1007/s00192-026-06879-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Barbed sutures are increasingly used in minimally invasive pelvic reconstructive surgery but have been associated with rare postoperative complications. We present a case of delayed small bowel obstruction (SBO) due to barbed-suture entrapment after laparoscopic sacrocervicopexy, and review the current literature to characterize the presentation, mechanisms, and management of this complication.</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical course, imaging, operative findings, and outcomes of a patient who developed SBO following manual laparoscopic sacrocervicopexy. A focused literature review was performed using PubMed to identify reported cases of barbed-suture-related SBO following laparoscopic sacrocervicopexy or sacrocolpopexy.</p><p><strong>Results: </strong>The patient presented with characteristic symptoms of bowel obstruction. CT imaging revealed early SBO with a transition point in the anterior pelvis. Diagnostic laparoscopy identified distal small bowel mesentery entrapped beneath a barbed suture from the prior sacrocervicopexy. Simple removal of the entrapping suture resolved the obstruction without need for bowel resection. A literature review identified five reported cases of SBO secondary to barbed-suture use in sacrocervicopexy/sacrocolpopexy procedures. In the limited published cases, most patients were successfully managed laparoscopically.</p><p><strong>Conclusions: </strong>Small bowel obstruction secondary to barbed-suture entrapment is a rare but serious complication following sacrocervicopexy/sacrocolpopexy. Early recognition and prompt laparoscopic intervention are often associated with successful management without bowel compromise. Surgeons should employ a meticulous technique when using barbed sutures, including proper tail management and complete peritoneal coverage. Future efforts should be aimed at reducing this complication by way of materials innovation and clinical guideline development.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Urogynecology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00192-026-06879-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction and hypothesis: Barbed sutures are increasingly used in minimally invasive pelvic reconstructive surgery but have been associated with rare postoperative complications. We present a case of delayed small bowel obstruction (SBO) due to barbed-suture entrapment after laparoscopic sacrocervicopexy, and review the current literature to characterize the presentation, mechanisms, and management of this complication.
Methods: We retrospectively reviewed the clinical course, imaging, operative findings, and outcomes of a patient who developed SBO following manual laparoscopic sacrocervicopexy. A focused literature review was performed using PubMed to identify reported cases of barbed-suture-related SBO following laparoscopic sacrocervicopexy or sacrocolpopexy.
Results: The patient presented with characteristic symptoms of bowel obstruction. CT imaging revealed early SBO with a transition point in the anterior pelvis. Diagnostic laparoscopy identified distal small bowel mesentery entrapped beneath a barbed suture from the prior sacrocervicopexy. Simple removal of the entrapping suture resolved the obstruction without need for bowel resection. A literature review identified five reported cases of SBO secondary to barbed-suture use in sacrocervicopexy/sacrocolpopexy procedures. In the limited published cases, most patients were successfully managed laparoscopically.
Conclusions: Small bowel obstruction secondary to barbed-suture entrapment is a rare but serious complication following sacrocervicopexy/sacrocolpopexy. Early recognition and prompt laparoscopic intervention are often associated with successful management without bowel compromise. Surgeons should employ a meticulous technique when using barbed sutures, including proper tail management and complete peritoneal coverage. Future efforts should be aimed at reducing this complication by way of materials innovation and clinical guideline development.
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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