Laparoscopic Myomectomy Using Barbed or Conventional Sutures

Laparoscopic Myomectomy Using Barbed or Conventional Sutures . A Randomized Controlled Trial

The aim of this study is to compare operative data and early postoperative outcomes of laparoscopic myomectomy using barbed sutures with those of laparoscopic myomectomy using conventional sutures .

• Till now , there is only one small randomized controllrd study (n=22 in each arm) which compared the use of barbed suture with conventional suture in laparoscopic myomectomy .The myoma bed was closed with either conventional polyglactin suture or unidirectional barbed suture . The operative time was shorter in the barbed suture group (73.3 ± 21.4 min Vs. 80.7 ± 18.6 min) but this difference failed to reach statistical significance because of small sample size . However, the time required to suture the myoma beds was significantly lower in the barbed suture group .

Inclusion Criteria:

• the presence of one to three symptomatic intramural or subserosal myomas (with largest fibroid diameter less than 10 cm).

Exclusion Criteria:

• submucosal myoma
• calcified myomas
• uterine size more than 16 weeks
• suspension of genital malignancy
• coagulation defects or concurrent anticoagulant therapy
• pregnancy
• compromised cardiopulmonary status
• previous treatment with gonadotropin-releasing hormone analogue
• contraindications for general anesthesia.