Management of the cut end of a barbed suture

Abstract

  Barbed sutures are widely used to suture the myometrium in cases of cesarean delivery and myomectomy, as well as to suture the vaginal stump in hysterectomy. Although barbed sutures facilitate rapid and accurate tissue approximation, protrusion of the cut end of the suture into the abdominal cavity and subsequent entanglement in the intestinal tract or mesentery can cause bowel obstruction or volvulus. We report a case of strangulated ileus after laparoscopic myomectomy using barbed sutures. We ligated the cut end of the barbed suture using another suture and cut it as short as possible. The patient has shown no complications postoperatively. We report our novel suturing method, which could be useful clinically in such cases.