Barbed vs Polyglactin 910: A Comparative Study of the Efficacy in Laparoscopic Vaginal Cuff Closure

Context: Total laparoscopic hysterectomy (TLH) is a popular mode of hysterectomy in the recent times. One of the principal steps is vaginal cuff closure, with many variations in surgical technique and materials. Intracorporeal suturing and knot-tying are crucial steps and are considered to be the most technically difficult skills. To overcome these challenges and learning curve, various measures have been emerging. One among them is the introduction of barbed suture, a new class of suture material. Aim: To evaluate whether the use of barbed suture for vaginal cuff closure during TLH reduced the surgical difficulty and suturing time when compared to polyglactin 910 suture. Materials and methods: This randomized comparative study included 100 patients divided into two groups of 50 each, who underwent TLH with vault closure using either barbed sutures or polyglactin 910. Demographic details, indication for surgery, intraoperative complications, mean suturing time, surgeon difficulty, and average hospital stay were compared between the two groups. Statistical analysis: Student t test for continuous variables and Fischer exact test for categorical variables. p values ≤ 0.05 were considered significant. Results: Use of barbed suture has significantly reduced the suturing time for vaginal vault closure (5.39 vs 6.9 minutes, p value < 0.0001) as well as the technical difficulty in laparoscopic suturing ( p value < 0.0001) when compared to that with polyglactin 910. Conclusion: The introduction of barbed sutures for vault closure during TLH not just reduces the suturing time but is also technically less demanding, making it a potential asset in laparoscopic hysterectomies.