ArticleSurgical endoscopy2026
Barbed continuous suture reduces the risk of specimen extraction site hernia in high-risk obese patients: a CT-based analysis.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundExtraction-site hernia (ESH) is a recognized complication after laparoscopic colorectal surgery. Obesity increases the risk of ESH, may make fascial closure more difficult, and has been identified as a risk factor. We investigated whether barbed continuous suturing reduces the incidence of ESH compared with interrupted suturing, particularly in obese patients.
methodsWe retrospectively analyzed 193 patients who underwent laparoscopic colorectal surgery at a single center. Closure technique transitioned from interrupted sutures (n = 93) to barbed continuous sutures (n = 100). Propensity score matching using 11 covariates yielded 79 matched pairs. ESH was assessed by computed tomography at 12 months and at the end of follow-up.
resultsIn the matched cohort, the 12-month incidence of ESH was significantly lower in the barbed continuous group than in the interrupted group (10.1 vs. 32.9%; P = 0.0008). Over the full follow-up period, the overall incidence was 15.2 vs. 38.0% (P = 0.0020). Multivariable analysis identified barbed continuous suturing as an independent protective factor (aOR 0.16; 95% CI 0.06-0.41; P = 0.0003), whereas higher BMI remained an independent risk factor (aOR 1.16 per 1 kg/m
conclusionBarbed continuous suturing was associated with a lower incidence of ESH after laparoscopic colorectal surgery, particularly in obese patients. Prospective multicenter studies are needed to confirm these findings and define the significance of hernia repair.
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