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Published in: World Journal of Surgical Oncology 1/2013

Open Access 01-12-2013 | Technical innovations

Laparoscopic technique and safety experience with barbed suture closure for pelvic cavity after abdominoperineal resection

Authors: Nobuhisa Matsuhashi, Takao Takahashi, Kenichi Nonaka, Toshiyuki Tanahashi, Hisashi Imai, Yoshiyuki Sasaki, Yoshihiro Tanaka, Naoki Okumura, Kazuya Yamaguchi, Shinji Osada, Kazuhiro Yoshida

Published in: World Journal of Surgical Oncology | Issue 1/2013

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Abstract

Background

Between April 2005 and December 2012, we performed laparoscopic colorectal resection with regional lymph node dissection on 273 cases of colorectal cancer patients. However, Laparoscopic rectal cancer surgery requires a high degree of skill. Any surgeon who is going to embark on these difficult resections should have at a minimum laparoscopic suturing skills in order to be able to close the peritoneal defect.

Methods

In laparoscopic surgery for rectal cancer, the intracorporeal suture technique required to close the pelvic cavity is very difficult. Barbed sutures have recently been proposed to facilitate laparoscopic suturing. Two patients with rectal cancer who underwent laparoscopic abdominoperineal resection (APR) with intracorporeal closure of the pelvic cavity from September to October 2012 were enrolled in this study.

Results

We present our initial experience of two consecutive cases of intracorporeal closure of the pelvic cavity by totally laparoscopic APR. After clinical follow-up, the two patients have no complaints and have shown no signs of recurrence.

Conclusions

We hypothesized that barbed sutures could potentially improve the efficiency of intracorporeal closure of the pelvic cavity after laparoscopic APR. Further, we expect that use of the V-Loc™ will reduce intra-operative stress on the endoscopic surgeon.
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Literature
1.
go back to reference Sackier JM, Berci G, Hiatt JR, Hartunian S: Laparoscopic abdominoperineal resection of the rectum. Br J Surg. 1992, 79: 1207-1208. 10.1002/bjs.1800791137.CrossRefPubMed Sackier JM, Berci G, Hiatt JR, Hartunian S: Laparoscopic abdominoperineal resection of the rectum. Br J Surg. 1992, 79: 1207-1208. 10.1002/bjs.1800791137.CrossRefPubMed
2.
go back to reference Ng SSM, Leung KL, Lee JFY, Yiu RYC, Li JCM, Teoh AYB, Leung WW: Laparoscopic-Assisted Versus Open Abdominoperineal Resection for Low Rectal Cancer: A Prospective Randomized Trial. Ann Surg Oncol. 2008, 15: 2418-2425. 10.1245/s10434-008-9895-0.CrossRefPubMed Ng SSM, Leung KL, Lee JFY, Yiu RYC, Li JCM, Teoh AYB, Leung WW: Laparoscopic-Assisted Versus Open Abdominoperineal Resection for Low Rectal Cancer: A Prospective Randomized Trial. Ann Surg Oncol. 2008, 15: 2418-2425. 10.1245/s10434-008-9895-0.CrossRefPubMed
3.
go back to reference Nagtegaal ID, Quirke P: What is the role for the circumferential margin in the modern treatment of rectal cancer?. J Clin Oncol. 2008, 26: 303-12.21. 10.1200/JCO.2007.12.7027.CrossRefPubMed Nagtegaal ID, Quirke P: What is the role for the circumferential margin in the modern treatment of rectal cancer?. J Clin Oncol. 2008, 26: 303-12.21. 10.1200/JCO.2007.12.7027.CrossRefPubMed
4.
go back to reference Raftopoulos I, Reed JF, Bergamaschi R: Circumferential resection margin involvement after laparoscopic abdominoperineal resection for rectal cancer. Colorectal Dis. 2012, 14: 431-437. 10.1111/j.1463-1318.2011.02626.x.CrossRefPubMed Raftopoulos I, Reed JF, Bergamaschi R: Circumferential resection margin involvement after laparoscopic abdominoperineal resection for rectal cancer. Colorectal Dis. 2012, 14: 431-437. 10.1111/j.1463-1318.2011.02626.x.CrossRefPubMed
5.
go back to reference Pikarsky AJ, Rosenthal R, Weiss EG, Wexner SD: Laparoscopic total mesorectal excision. Surg Endosc. 2002, 16: 558-562. 10.1007/s00464-001-8250-3.CrossRefPubMed Pikarsky AJ, Rosenthal R, Weiss EG, Wexner SD: Laparoscopic total mesorectal excision. Surg Endosc. 2002, 16: 558-562. 10.1007/s00464-001-8250-3.CrossRefPubMed
6.
go back to reference Ohtani H, Tamamori Y, Azuma Y, Nishiquch Y, Maeda K, Hirakawa K: A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy assisted and conventional open surgery for rectal cancer. J Gastrointest Surg. 2011, 15: 1375-1385. 10.1007/s11605-011-1547-1.CrossRefPubMed Ohtani H, Tamamori Y, Azuma Y, Nishiquch Y, Maeda K, Hirakawa K: A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy assisted and conventional open surgery for rectal cancer. J Gastrointest Surg. 2011, 15: 1375-1385. 10.1007/s11605-011-1547-1.CrossRefPubMed
7.
go back to reference Nagtegaal ID, Van de Velde CJH, Marijnen CAM, Van Krieken JHJM, Quirke P: Low rectal cancer: a call for a change of approach in abdominoperineal resection. J Clin Oncol. 2005, 23: 9257-9264. 10.1200/JCO.2005.02.9231.CrossRefPubMed Nagtegaal ID, Van de Velde CJH, Marijnen CAM, Van Krieken JHJM, Quirke P: Low rectal cancer: a call for a change of approach in abdominoperineal resection. J Clin Oncol. 2005, 23: 9257-9264. 10.1200/JCO.2005.02.9231.CrossRefPubMed
8.
go back to reference Larach SW, Salomon MC, Williamson PR, Goldstein E: Laparoscopic assisted abdominoperineal resection. Surg Laparosc Endosc. 1993, 3: 115-118.PubMed Larach SW, Salomon MC, Williamson PR, Goldstein E: Laparoscopic assisted abdominoperineal resection. Surg Laparosc Endosc. 1993, 3: 115-118.PubMed
9.
go back to reference Iroatulam AJ, Agachan F, Alabaz O, Weiss EG, Nogueras JJ, Wexner SD: Laparoscopic abdominoperineal resection for anorectal cancer. Am Surg. 1998, 64: 12-18.PubMed Iroatulam AJ, Agachan F, Alabaz O, Weiss EG, Nogueras JJ, Wexner SD: Laparoscopic abdominoperineal resection for anorectal cancer. Am Surg. 1998, 64: 12-18.PubMed
10.
go back to reference Wu JS, Birnbaum EH, Fleshman JW: Early experience with laparoscopic abdominoperineal resection. Surg Endosc. 1997, 11: 449-455. 10.1007/s004649900388.CrossRefPubMed Wu JS, Birnbaum EH, Fleshman JW: Early experience with laparoscopic abdominoperineal resection. Surg Endosc. 1997, 11: 449-455. 10.1007/s004649900388.CrossRefPubMed
11.
go back to reference Duepree HJ, Senagore AJ, Delaney CP, Fazio VW: Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg. 2003, 197: 177-181. 10.1016/S1072-7515(03)00232-1.CrossRefPubMed Duepree HJ, Senagore AJ, Delaney CP, Fazio VW: Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg. 2003, 197: 177-181. 10.1016/S1072-7515(03)00232-1.CrossRefPubMed
12.
go back to reference Scheidbach H, Rose J, Huegel O, Yildirim C, Köckerling F: Results of laparoscopic treatment of rectal cancer: analysis of 520 patients. Tech Coloproctol. 2004, 8 (Suppl 1): s22-s244.CrossRefPubMed Scheidbach H, Rose J, Huegel O, Yildirim C, Köckerling F: Results of laparoscopic treatment of rectal cancer: analysis of 520 patients. Tech Coloproctol. 2004, 8 (Suppl 1): s22-s244.CrossRefPubMed
13.
go back to reference Tewari AK, Srivastava A, Sooriakumaran P, Slevin A, Grover S, Waldman O, Rajan S, Herman M, Berryhill R, Leung R: Use of a novel absorbable barbed plastic surgical suture enables a ‘self-cinching’ technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times. J Endourol. 2010, 24: 1645-1650. 10.1089/end.2010.0316.CrossRefPubMed Tewari AK, Srivastava A, Sooriakumaran P, Slevin A, Grover S, Waldman O, Rajan S, Herman M, Berryhill R, Leung R: Use of a novel absorbable barbed plastic surgical suture enables a ‘self-cinching’ technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times. J Endourol. 2010, 24: 1645-1650. 10.1089/end.2010.0316.CrossRefPubMed
14.
go back to reference Kaul S, Sammon J, Bhandari A, Peabody J, Rogers CG, Menon M: A novel method of urethrovesical anastomosis duri’ng robot-assisted radical prostatectomy using a unidirectional barbed wound closure device: feasibility study and early outcomes in 51 patients. J Endourol. 2010, 24: 1789-1793. 10.1089/end.2010.0200.CrossRefPubMed Kaul S, Sammon J, Bhandari A, Peabody J, Rogers CG, Menon M: A novel method of urethrovesical anastomosis duri’ng robot-assisted radical prostatectomy using a unidirectional barbed wound closure device: feasibility study and early outcomes in 51 patients. J Endourol. 2010, 24: 1789-1793. 10.1089/end.2010.0200.CrossRefPubMed
15.
go back to reference Weld KJ, Ames CD, Hruby G, Humphrey PA, Landman J: Evaluation of a novel knotless self-anchoring suture material for urinary tract reconstruction. Urology. 2006, 67: 1133-1137. 10.1016/j.urology.2005.12.022.CrossRefPubMed Weld KJ, Ames CD, Hruby G, Humphrey PA, Landman J: Evaluation of a novel knotless self-anchoring suture material for urinary tract reconstruction. Urology. 2006, 67: 1133-1137. 10.1016/j.urology.2005.12.022.CrossRefPubMed
16.
go back to reference Moran ME, Marsh C, Perrotti M: Bidirectional-barbed sutured knotless running anastomosis v classic Van Velthoven suturing in a model system. J Endourol. 2007, 21: 1175-1178. 10.1089/end.2007.9913.CrossRefPubMed Moran ME, Marsh C, Perrotti M: Bidirectional-barbed sutured knotless running anastomosis v classic Van Velthoven suturing in a model system. J Endourol. 2007, 21: 1175-1178. 10.1089/end.2007.9913.CrossRefPubMed
17.
go back to reference Hruby G, Weld KJ, Marruffo F, Collins S, Durak E, Mitchell R, Herron A, Landman J: Comparison of novel tissue apposing device and standard anastomotic technique for Vesicourethral anastomoses. Urology. 2007, 70: 190-195.CrossRefPubMed Hruby G, Weld KJ, Marruffo F, Collins S, Durak E, Mitchell R, Herron A, Landman J: Comparison of novel tissue apposing device and standard anastomotic technique for Vesicourethral anastomoses. Urology. 2007, 70: 190-195.CrossRefPubMed
18.
go back to reference Demyttenaere SV, Nau P, Henn M, Beck C, Zaruby J, Primavera M, Kirsch D, Miller J, Liu JJ, Bellizzi A, Melvin WS: Barbed suture for gastrointestinal closure: a randomized control trial. Surg Innov. 2009, 16: 237-242. 10.1177/1553350609342988.CrossRefPubMed Demyttenaere SV, Nau P, Henn M, Beck C, Zaruby J, Primavera M, Kirsch D, Miller J, Liu JJ, Bellizzi A, Melvin WS: Barbed suture for gastrointestinal closure: a randomized control trial. Surg Innov. 2009, 16: 237-242. 10.1177/1553350609342988.CrossRefPubMed
19.
go back to reference Alessandri F, Remorgida V, Venturini PL, Ferrero S: Unidirectional barbed suture versus continuous suture with intracorporeal knots in laparoscopic myomectomy: a randomized study. J Minim Invasive Gynecol. 2010, 17: 725-729. 10.1016/j.jmig.2010.06.007.CrossRefPubMed Alessandri F, Remorgida V, Venturini PL, Ferrero S: Unidirectional barbed suture versus continuous suture with intracorporeal knots in laparoscopic myomectomy: a randomized study. J Minim Invasive Gynecol. 2010, 17: 725-729. 10.1016/j.jmig.2010.06.007.CrossRefPubMed
20.
go back to reference Sammon J, Petros F, Sukumar S, Bhandari A, Kaul S, Menon M, Rogers C: Barbed suture for renorrhaphy during robot-assisted partial nephrectomy. J Endourol. 2011, 25: 529-533. 10.1089/end.2010.0455.CrossRefPubMed Sammon J, Petros F, Sukumar S, Bhandari A, Kaul S, Menon M, Rogers C: Barbed suture for renorrhaphy during robot-assisted partial nephrectomy. J Endourol. 2011, 25: 529-533. 10.1089/end.2010.0455.CrossRefPubMed
21.
go back to reference Lee SW, Nomura E, Tokuhara T, Kawai M, Matsuhashi N, Yokoyama K, Fujioka H, Hiramatsu M, Okuda J, Uchiyama K: Laparoscopic technique and initial experience with knotless, unidirectional barbed suture closure for staple-conserving, delta-shaped gastroduodenostomy after distal gastrectomy. J Am Coll Surg. 2011, 213: e39-e45. 10.1016/j.jamcollsurg.2011.09.004.CrossRefPubMed Lee SW, Nomura E, Tokuhara T, Kawai M, Matsuhashi N, Yokoyama K, Fujioka H, Hiramatsu M, Okuda J, Uchiyama K: Laparoscopic technique and initial experience with knotless, unidirectional barbed suture closure for staple-conserving, delta-shaped gastroduodenostomy after distal gastrectomy. J Am Coll Surg. 2011, 213: e39-e45. 10.1016/j.jamcollsurg.2011.09.004.CrossRefPubMed
22.
go back to reference Kitano S, Isono Y, Moriyama M: Laparoscopy-assisted Billroth I gastrectomy. Surg laparosc Endosc. 1994, 4: 146-148.PubMed Kitano S, Isono Y, Moriyama M: Laparoscopy-assisted Billroth I gastrectomy. Surg laparosc Endosc. 1994, 4: 146-148.PubMed
23.
go back to reference Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study Group: A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007, 245: 68-72. 10.1097/01.sla.0000225364.03133.f8.PubMedCentralCrossRefPubMed Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study Group: A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007, 245: 68-72. 10.1097/01.sla.0000225364.03133.f8.PubMedCentralCrossRefPubMed
Metadata
Title
Laparoscopic technique and safety experience with barbed suture closure for pelvic cavity after abdominoperineal resection
Authors
Nobuhisa Matsuhashi
Takao Takahashi
Kenichi Nonaka
Toshiyuki Tanahashi
Hisashi Imai
Yoshiyuki Sasaki
Yoshihiro Tanaka
Naoki Okumura
Kazuya Yamaguchi
Shinji Osada
Kazuhiro Yoshida
Publication date
01-12-2013
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2013
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-11-115

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