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Chying-Chyuan Chan 1, 2, Chen-Hui Chin 3, Ling-Shuan Chuang 1, Ling-Yu Chang 1 1 Department of Obstetrics and Gynecology, Taipei City Hospital, Zhongxiao.

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Presentation on theme: "Chying-Chyuan Chan 1, 2, Chen-Hui Chin 3, Ling-Shuan Chuang 1, Ling-Yu Chang 1 1 Department of Obstetrics and Gynecology, Taipei City Hospital, Zhongxiao."— Presentation transcript:

1 Chying-Chyuan Chan 1, 2, Chen-Hui Chin 3, Ling-Shuan Chuang 1, Ling-Yu Chang 1 1 Department of Obstetrics and Gynecology, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan 2 National Defense Medical Center, Taipei, Taiwan 3 Department of Anesthesia, Taipei City Hospital, Woman and Child Branch, Taipei, Taiwan Problem Statement: Hemostatic control, suturing, and renovating leiomyoma are the most important procedures associated with laparoscopic myomectomy. When compared to the normal situation, suturing and tieing off using slender instruments are more imprecise and more difficult. As a result, problems may occur, such as when the joining of tissue is not strong enough and when there are difficulties carrying out stypsis during suturing and cross-cutting. Knotless wound closure device is a superior device that is equipped with an efficient barb and welded loop design. This suture invention is able to help the surgeon to close a wound, to stabilized the closure and to tie off rapidly. Methods: We applied this wound closure device to laparoscopic myomectomy with the aim of diminishing surgery time, reducing blood loss and reducing the number of complication; such improvement ought to result in better uterus recovery and pregnancy.This prospective study evaluated data on the efficacy of treatment of 62 women who underwent laparoscopic myomectomy at Taipei City Hospital Zhongxiao Branch from January 2010 through to August 2012. The patients were randomly assigned to either the Knotless wound closure device group or the 2-0 vicryl suture group. Results: The two groups were similar in terms of age, body weight, delivery number, hemoglobin and hematocrit before surgery. After surgery, blood loss, operation time, change in hemoglobin, change in hematocrit and the presence of uterus defects among the knotless wound closure device group were significant less than among the vicryl group. There are 26 patients pregnant after accepted surgery within 2 years. 12 of them are classified as Knotless wound closure device group and the others are 2-O Vicryl. Among these 26 patients, 1 patient classified as 2-O Vicryl has received hysterectomy cause of uterine rupture on the timing of the 24 week during her pregnancy, and the others have taken Cesarean Section successfully for childbirth. Conclusion: When compared with traditional suture material, the knotless wound closure device, which is equipped with an efficient barb and welded loop design, allows the surgeon to stably close any wound rapidly without having to tie-off separately. The wound margin is held firmly together, which is especially important during the critical stage of wound heal over and the stage of pregnancy; furthermore, the sutures are absorbable in 180 days. In conclusion, the knotless wound closure device brings a lot of benefits when used for laparoscopic myomectomy. The V-Loc™ 180 group (a),and the 2-0 vicryl suture group(b) Ultrasound exam before operation(1) and after operation finished 3months (2)


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