Small bowel obstruction from barbed suture following laparoscopic myomectomy—A case report

• A case of acute bowel obstruction caused by the use of barbed suture in laparoscopic myomectomy.
• Bowel complications associated with barbed suture were seldom reported despite it is increasingly used in surgery today.
• Some recommendations arising from this case may help to avoid or reduce this complication.
• A high index of suspicion is necessary in making an early diagnosis and prompt action should be taken to alleviate major bowel complications due to barbed suture.

Myomectomy is commonly performed for symptomatic fibroids in women who wish to conserve fertility. Laparoscopic myomectomy provides advantages as a minimally invasive procedure. To facilitate the closure of the uterine wound after enucleation of the fibroid, barbed sutures have been introduced as they can shorten the operative time and reduce the amount of bleeding. However, the use of barbed suture is not without risk. There were a few reports on the risks of barbed sutures in the literature. We report herein a case of acute abdomen because of small bowel entrapment and obstruction following the use of barbed suture in laparoscopic myomectomy. Surgeons using barbed suture in myomectomy should be vigilant on the possibility of this bowel complication whenever adverse clinical situation arises as the outcome could be serious if the condition was left unchecked.