Reproductive Outcomes after Laparoscopic Myomectomy: Conventional versus Barbed Suture

The research protocol of this retrospective cohort study was approved by the local ethics committee (IRB No. IEC-PH-2020-GYN-003 dated 15th March 2020). The study was conducted between April-May 2020. Clinical records of the women who had undergone laparoscopic myomectomy for uterine leiomyomas from January 2004 to December 2017 in our tertiary care center were retrieved. All women within the reproductive age group (20 to 45 years) who underwent laparoscopic myomectomy were included in the study. Written informed consent for data collection for research purposes was obtained from all patients. Patients who did not give consent, patients in whom the myometrium was not sutured, and those in whom multiple suture materials were used for uterine defect closure were excluded. They were categorized into two groups based on the type of suture material used – group A, women in whom non-barbed (PolysorbTM; Covidien, Mansfield, MA – LactomerTM a glycolide/lactide copolymer) sutures were used, and group B, women in whom barbed sutures (QuillTM; SRS, Westwood, MA - polydioxanone and V-LocTM; Covidien, Mansfield, MA - synthetic polyester composed of glycolide, dioxanone, and trimethylene carbonate) were used. The barbed suture was introduced in our institution in 2010, and since then, it has been used predominantly. The non-barbed (group A) patients belonged to 2004 - 2009 and the barbed (group B) patients to 2010 - 2017.
All the data regarding clinical presentation, intra-operative findings, intra-operative and postoperative complications, and hospital stay were collected and statistically analyzed. Patients were sent a postal questionnaire or contacted telephonically, and data was collected on pregnancy desire, success in conception, time to achieve pregnancy after surgery, whether they have undergone assisted reproductive technology (ART), gestational weeks at delivery, mode of delivery, and pregnancy complications.