Small bowel obstruction secondary to barbed sutures in bariatric surgery: a cautionary tale.
ANZ J Surg
; 94(7-8): 1313-1316, 2024.
Article
em En
| MEDLINE
| ID: mdl-38407555
ABSTRACT
BACKGROUND:
Laparoscopic bariatric surgery relies on technically challenging intracorporeal suturing for critical parts of the operation. Barbed sutures have been developed to provide an alternative to suturing for certain manoeuvres within a procedure. Barbed sutures theoretically negate the need for knot tying and allow for continuous application of tension; however the barbs can unintentionally adhere to surrounding tissues. We describe a case series of three patients who developed V-Loc™ (barbed) suture related small bowel obstruction (SBO) to promote awareness of this unusual but preventable complication.METHODS:
Medical records of patients diagnosed with V-Loc™ related SBO between 2018 and 2021 at a tertiary centre were reviewed. Data regarding presentation, diagnosis, management and outcomes were obtained.RESULTS:
Three patients were identified where V-Loc™ sutures were aetiologically related to early post-surgical small bowel obstruction secondary to small bowel adherence to barbed suture tail or adhesions between barbed suture tail and unintended viscera. In these cases, non-absorbable V-Loc™ sutures were used to close the small bowel mesenteric defect at Roux-en-Y gastric bypass surgery. All patients required adhesiolysis at re-look laparoscopy prior to resolution. All patients were discharged home well after relook laparoscopy.CONCLUSION:
Overly long or exposed V-Loc™ suture tails can result in SBO following laparoscopic bariatric surgery. Cutting the suture tail as close as practical to the final throw of the suture and/or covering exposed suture ends may prevent this complication.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Suturas
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Técnicas de Sutura
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Laparoscopia
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Obstrução Intestinal
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Intestino Delgado
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
ANZ J Surg
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Austrália