Journal of Minimally Invasive Surgery

The Korean Society of Endoscopic & Laparoscopic Surgeons (대한내시경복강경외과학회)
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The Overlapping Running Suture Method Using Single Knotless Barbed Absorbable Suture Material for Abdominal Wall Closure after Single Incision Laparoscopic Appendectomy: Comparison with the Traditional Interrupted Closure Technique

  • Kim, Dong Hyun (Department of Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Park, Jung Ho (Department of Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Joo, Jung Il (Department of Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Jeon, Jang Yong (Department of Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Lim, Sang Woo (Department of Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital)
  • Received : 2018.06.27
  • Accepted : 2018.09.04
  • Published : 2018.12.15
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Abstract

Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.

Keywords

References

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