Introduction Endometrioma is an ovarian pseudocyst that arises from the growth of ectopic endometriotic deposits within the ovary [1]. Endometriomas are usually seen in women of reproductive age. Pelvic pain, dyspareunia, rectal symptoms, urinary symptoms and infertility are the main complaints of patients with endometriomas [2]. Surgery is usually indicated in patients with severe pain not responding to medical treatment , infertile women and prior to IVF-ET [3]. Surgical management of endometriomas can be performed by open, laparoscopic or robotic approaches. In the recent years, laparoscopic approach has become the golden standard surgical approach for management of endometriomas [4]. Laparoscopy has several advantages over …show more content…
Three types of barbed sutures are currently available in the market: the Quill (Angiotech Pharmaceuticals), the Stratafix (Johnson and Johnson) and the V-Loc (Covidien). Quill and Stratafix are bidirectional barbed sutures that have two needles swaged onto both ends of the suture. V-Loc is a unidirectional barbed suture that has a loop at one end of the suture and a needle swaged onto the other end [10-13] When compared with conventional smooth suture, barbed suture has external barbs that anchor the suture to the tissues and prevent the retrograde movement of suture thread during suturing. Consequently, laparoscopic suturing can be performed easily without the need for suture locking, applying traction on suture thread by the assistant between the throws or tying knots at both ends of the suture line [10–13]. In gynecology, barbed sutures have been used in minimally invasive myomectomy ,hysterectomy and sacrocolpopexy. There is a growing body of evidence that the use of barbed sutures in these procedures facilitates laparoscopic suturing and significantly reduces suturing time, total operative time and intraoperative blood loss