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Comparative Study
. 2025 Feb;51(2):e16251.
doi: 10.1111/jog.16251.

Comparing the impact of three-dimensional display systems and barbed V-LOC™ sutures in laparoscopic hysterectomy: A retrospective cohort study

Can Tercan  1 , Emrah Dagdeviren  1 , Ali Selcuk Yeniocak  1 , Sultan Can  2 , Fatih Aktoz  3
Affiliations
Comparative Study

Comparing the impact of three-dimensional display systems and barbed V-LOC™ sutures in laparoscopic hysterectomy: A retrospective cohort study

Can Tercan et al. J Obstet Gynaecol Res. 2025 Feb.

Abstract

Aim: This study aims to evaluate the impact of two-dimensional (2D) versus three-dimensional (3D) imaging systems and barbed versus standard absorbable multifilament sutures on surgical times and complications in total laparoscopic hysterectomy.

Methods: A retrospective cohort study was conducted at a tertiary hospital between May 2020 and September 2024. Patients who underwent total laparoscopic hysterectomy were categorized into four groups based on imaging system (UltraHD-2D vs. FullHD-3D) and suture type (VICRYL™ multifilament suture interrupted figure-of-8 technique vs. V-LOC™ barbed suture running technique). Primary outcomes included vaginal cuff closure time and total operation duration. Secondary outcomes were mean suturing time, perceived difficulty, and postoperative complications.

Results: A total of 159 patients were analyzed. Vaginal cuff closure time was significantly shorter with 3D imaging systems compared to 2D systems when VICRYL™ sutures were used (13.85 ± 4.30 vs. 21.17 ± 5.13 min, p < 0.001). No significant difference was observed between imaging systems when V-LOC™ barbed sutures were used. Across both systems, V-LOC™ sutures consistently reduced suturing time compared to VICRYL™ sutures (p < 0.001). Surgeon-perceived difficulty was lower with V-LOC™ sutures, particularly in 2D systems. No significant difference in complication rates was observed between groups (p = 0.188).

Conclusion: The use of 3D imaging systems in total laparoscopic hysterectomy significantly reduces vaginal cuff closure duration and overall operative time with VICRYL™ sutures, while V-LOC™ sutures consistently enable faster procedures across both imaging modalities. These findings suggest that 3D imaging systems and barbed sutures may enhance surgical efficiency without increasing complication rates.

Keywords: barbed sutures; full HD 3D; total laparoscopic hysterectomy; ultra HD 2D.

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