Barbed Suture Versus Traditional Suture Material for Laparoscopic Myomectomy

• Operative time [ Designated as safety issue: No ]
  We will record the operative time from beginning to completion of suturing each fibroid separately, as well as total operative time for the entire procedure.
  
  

• Blood loss [ Time Frame: Intra-operative ] [ Designated as safety issue: No ]
  We will subtract the amount of irrigation fluid used from the total amount of fluid suctioned during the procedure to arrive at an estimated blood loss in millilitres. We will also measure the patient's hemoglobin at the routine pre-operative visit and then on the morning of the first post-operative day to determine the difference in hemoglobin. The amount of intravenous fluids administered to the patients intra- and post-operatively will be documented in order to account for any changes in hemoglobin that are spurious due to fluid administration.
  
  
• Adverse events [ Time Frame: Intra-operatively until 6 weeks post-operatively ] [ Designated as safety issue: No ]
  All adverse events that occur until 6 weeks post-operatively will be documented including injury to the bladder, bowel, ureter or blood vessel, infection/abscess, fever, blood transfusion, readmission to hospital, re-operation, and venous thromboembolism.
  
  
• Hospital stay [ Designated as safety issue: No ]
  We will document the length of hospital stay post-operatively in days.
  
  
• Fertility and pregnancy-related outcomes [ Time Frame: 2 and 5 years post-operatively ] [ Designated as safety issue: No ]
  Telephone interviews will be conducted at 2 and 5 years post-operatively to determine pregnancy rates, live birth rates and adverse pregnancy outcomes of participants.
  
  

Although the laparoscopic myomectomy has benefits over the abdominal approach, such as less blood loss, less hemoglobin drop post-operatively, decreased post-operative pain and fewer overall complications, it is a difficult procedure, which often requires greater operative time to perform. In the current climate of attempting to reduce health care expenditures, even though the minimally invasive approach offers the advantage of reduced hospital stay, a deterrent for hospital administration and surgeons may be the increased operative time it may require. Barbed suture is a relatively new material available in gynecologic surgery. Barbs are cut into the suture with the barbs facing in a direction opposite that of the needle. The barbs allow for anchoring of the suture in tissues, which prevents migration and allows suturing without knot tying. This study will be a single-centre non-blinded randomized controlled trial comparing laparoscopic myomectomy with barbed suture versus traditional suture material.