Acute small bowel obstruction caused by barbed suture on the second day after laparoscopic hysterosacropexy: A case report and literature review

Abstract

Objective: To report a case of small bowel obstruction caused by barbed suture applied in hysterosacropexy, and possible solutions.

Case report: A 57-year-old woman underwent laparoscopic hysterosacropexy for a Stage 2 uterine prolapse, presenting with acute abdominal pain and a bowel obstruction syndrome 2 days following the surgery. Conservative treatment was given, but the symptoms did not improve and gradually became worse. Diagnostic laparoscopy was performed on the 7^th day after the hysterosacropexy, and the volvulus was found. The residual end of the barbed V-Loc adopted in the peritoneal closure was incidentally hooked to the mesentery and caused small bowel obstruction. The redundant V-Loc was released and cut off at 2 cm. Neither bowel ischemia nor significant bowel injury was noted. Two days later, she was discharged without complication.

Conclusion: A barbed suture has a risk of bowel obstruction when used in surgery. To avoid a grave prognosis, early diagnosis and prompt management of complication is necessary.

Keywords: barbed suture; hysterosacropexy; intestinal obstruction; laparoscopy.