The use of bidirectional barbed suture in laparoscopic myomectomy and total laparoscopic hysterectomy.

Bidirectional barbed suture is a new design that incorporates tiny barbs spaced evenly along the length of the suture cut facing in opposite directions from the midpoint. Unlike the smooth-textured traditional suture, the bidirectional barbs on this new product introduce a new paradigm in which wound tension is evenly distributed across the length of the suture line rather than at the knotted end. No knots are required with bidirectional barbed suture. We present a small case series with bidirectional barbed suture to close myometrial defects in laparoscopic myomectomies and vaginal cuffs in total laparoscopic hysterectomies. On the basis of our early experience, we are optimistic that this new suture material is a potentially valuable tool for gynecologic surgeons.