Volume 29, Issue 158, April 2025

Challenging the knot: a review of barbed sutures in gastrointestinal surgery

Mateusz Leśniewski^1♦, Julia Krasnodębska¹, Karolina Stachyra², Anna Bieda³, Arkadiusz Zaremba⁴, Michał Kluska⁵, Przemysław Kwiatka⁶, Marta Borecka⁶, Maciej Wyskok⁷, Karolina Hanusz⁶

¹Czerniakowski Hospital, Warsaw, Poland
²1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
³The Independent Group of Public Ambulatory Care Institutions Warsaw, Poland
⁴Scanmed Rudolf Weigl Hospital in Blachownia, Poland
⁵Samodzielny Publiczny Szpital Kliniczny im. prof. W. Orłowskiego CMKP, Warsaw, Poland
⁶National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
⁷Academy of Silesia, Katowice, Poland

^♦Corresponding author
Czerniakowski Hospital, ul. Stępińska 19/25, 00-739 Warsaw, Poland

ABSTRACT

Introduction: Despite advances in laparoscopic techniques, intracorporeal suturing remains laborious and technically demanding. Barbed sutures have been introduced as a potential solution, but their role is still being evaluated. Methods: We conducted a literature search using PubMed, Scopus, and Google Scholar to identify studies using knotless sutures in gastrointestinal surgery. Results: Fourteen studies met the inclusion criteria. Most of the included studies focused on bariatric and colorectal procedures. In bariatric procedures, barbed sutures significantly reduced operative time. The safety of barbed sutures was comparable to traditional sutures, with no notable increase in leaks, bleeding, or strictures. Findings on the use of barbed sutures in colorectal surgery were mixed. Some studies reported time savings with knotless sutures, while others found no significant difference. Safety outcomes were similar between barbed and conventional sutures. Conclusions: Barbed sutures shortened operation times without increasing postoperative complications when used in bariatric procedures. The effectiveness of barbed sutures in colorectal surgery remains unclear. Although promising, using knotless sutures in minimally invasive surgery requires further research to evaluate long-term outcomes and refine surgical techniques.

Keywords: barbed sutures, bariatric surgery, colorectal surgery

Medical Science, 2025, 29, e60ms3555

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DOI: https://doi.org/10.54905/disssi.v29i158.e60ms3555

Published: 29 April 2025