225 Post-operative ileus with knotless barbed sutures€¦ · Barbed sutures have been well...
1
REFERENCES 1. Milone M et al. J Laparoendosc Adv Surg Tech 2013;23:911 2. Gys B et al. Obes Surg 2017;2:85 3. Jang SH et al. Ann Surg Treat Res 2017;92:501 Post-operative ileus with knotless barbed sutures V-Loc post bypass surgery: case report and review of the literature A. Litchinko, F. Cherbanyk, F. Pugin, B. Egger Department of Surgery HFR Fribourg - Cantonal Hospital, CH-1708 Fribourg METHODS A 25-year-old female presented with abdominal pain and severe nausea 7 days after laparoscopic gastric Bypass for morbid obesity. Clinical examination revealed an epigastric tenderness without any sign of peritonitis and laboratory reults were normal. CT-scan of the abdomen showed severe small bowel obstruction at the level of the Y-connection anastomosis requiring a surgical re-intervention (Fig 1). CONCLUSION Barbed sutures have been well evaluated in prospective studies and their efficacy and efficiency are nowadays well established. However, some cases of small bowel obstruction have been reported after gastric bypass surgery or other operations utilizing such barbed sutures. In this particular case, the uncovered part of the thread was causing a mechanical obstruction which forced us to do a re-intrevention. In order to avoid such complications the tail part of the thread ought to be covered and placed in a safe location when ever possible. OBJECTIVE Gastric Bypass is nowadays a well-established and a common surgical procedure for obese patient. Important steps of this surgery are the gastrointestinal barbed sutures. V-Loc™ sutures were shown to be quick, secure and effective to perform such anastomoses. Unidirectional and knotless sutures have greatly reduced the suturing steps. However, some complications have been reported in the literature. We describe here a case of small bowel obstruction caused by a barbed suture performed during laparoscopic gastric Bypass surgery for morbid obesity. RESULTS Explorative laparoscopy has been performed revealing an strong adhesion between the tail of the thread and the omentum causing small bowel obstruction and gastric dilatation (Fig 2a). Careful manipulation of the the adhesion at the proximal suture permitted to isolate and cut the V-Loc™ tail which solved the problem without any further action (Fig 2b). Figure 1. CT-scan showing small bowel obstruction Figure 2a. V-Loc™ suture anchored in the omentum Figure 2b. Final shortening of the barbed suture
Transcript of 225 Post-operative ileus with knotless barbed sutures€¦ · Barbed sutures have been well...
REFERENCES
1. Milone M et al. J Laparoendosc Adv Surg Tech 2013;23:9112. Gys B et al. Obes Surg 2017;2:853. Jang SH et al. Ann Surg Treat Res 2017;92:501
Post-operative ileus with knotless barbed sutures V-Loc post bypass surgery: case
report and review of the literature
A. Litchinko, F. Cherbanyk, F. Pugin, B. Egger
Department of Surgery HFR Fribourg - Cantonal Hospital, CH-1708 Fribourg
METHODS
A 25-year-old female presented with abdominal painand severe nausea 7 days after laparoscopic gastricBypass for morbid obesity. Clinical examinationrevealed an epigastric tenderness without any sign ofperitonitis and laboratory reults were normal. CT-scanof the abdomen showed severe small bowel obstructionat the level of the Y-connection anastomosis requiring asurgical re-intervention (Fig 1).
CONCLUSION
Barbed sutures have been well evaluated inprospective studies and their efficacy and efficiency arenowadays well established. However, some cases ofsmall bowel obstruction have been reported aftergastric bypass surgery or other operations utilizingsuch barbed sutures.In this particular case, the uncovered part of the threadwas causing a mechanical obstruction which forced usto do a re-intrevention. In order to avoid suchcomplications the tail part of the thread ought to becovered and placed in a safe location when everpossible.
OBJECTIVE
Gastric Bypass is nowadays a well-established and acommon surgical procedure for obese patient.Important steps of this surgery are the gastrointestinalbarbed sutures. V-Loc™ sutures were shown to bequick, secure and effective to perform suchanastomoses. Unidirectional and knotless sutures havegreatly reduced the suturing steps. However, somecomplications have been reported in the literature. Wedescribe here a case of small bowel obstruction causedby a barbed suture performed during laparoscopicgastric Bypass surgery for morbid obesity.
RESULTS
Explorative laparoscopy has been performed revealingan strong adhesion between the tail of the thread andthe omentum causing small bowel obstruction andgastric dilatation (Fig 2a). Careful manipulation of thethe adhesion at the proximal suture permitted to isolateand cut the V-Loc™ tail which solved the problemwithout any further action (Fig 2b).
Figure 1. CT-scan showing small bowel obstruction
Figure 2a. V-Loc™ suture anchored in the omentum
Figure 2b. Final shortening of the barbed suture
![New Continuous Barbed Suture Device with Stratafix for the ... · [1,2] The use of barbed sutures has been introduced gradually in laparoscopic procedures including myomectomy. In](https://static.fdocuments.net/doc/165x107/5f93d37ff7917f7c010cc3cb/new-continuous-barbed-suture-device-with-stratafix-for-the-12-the-use-of.jpg)
![1.18. PREVENTION: WOUND MANAGEMENT · 12/1/2018 · [22] Smith EL, DiSegna ST, Shukla PY, Matzkin EG. Barbed versus traditional sutures: closure time, cost, and wound related outcomes](https://static.fdocuments.net/doc/165x107/601568ca10e0ec38312addc2/118-prevention-wound-management-1212018-22-smith-el-disegna-st-shukla.jpg)
