AGES ASM/ISGE 15 Suturing at complications, techniques, needles and suture materials (1414)
In surgery the skill of suturing is an essential part of the training to become an all-round surgeon.
When a surgeon separates tissues the tissues have to be reconnected during and at the end of the surgery. Gynecological surgery is no exception to this rule. What does a gynecological surgeon need suturing for you will find in. The indications to use suturing in conventional gynecological endoscopic surgery are:
• To reconstruct anatomical & functional sites at surgery.
– The Uterus after Myomectomy.
– The Vagina after Hysterectomy.
– The Bladder after Endometriosis surgery or trauma.
– The Ureter after section.
– The Rectum after Endometriosis surgery or Trauma.
– The Ovary after Cystectomy.
• To Secure Bleeding.
• To suspend structures at surgery (Pelvic Floor Surgery and
out of the operation field).
• To reconstruct structures.
In emergency situations the sutures to use are braided sutures mainly because a limited amount of bipolar cautery can be used over braided sutures (0 -1) without the suture losing its tensile strength. Monofilament sutures disappear under bipolar coagulation over the suture. In normal situations monofilament sutures are preferred when dealing with delicate structures i.e. bowel and bladder. As for needles in emergency situation cutting or reverse cutting needles are the needles of choice. In normal circumstances rounded needles are the choice to suture bowel and bladder. Halve circle needles are preferred in emergency suturing. In normal circumstances straight needles have their place to suspend structures. In emergency situations rather big needles are preferred with a suture O or 1.
