Small bowel obstruction resulting from laparoscopic vaginal cuff closure with a barbed suture.

Surgical trends favor the minimally invasive approach for gynecologic procedures. Technology, equipment, and surgical materials have evolved to simplify technically challenging skills and decrease operative times to permit successful completion of procedures via the laparoscopic approach. However, with the introduction of new advances, surgeons must also be aware of potential complications that may arise. A barbed suture is an attractive suture option that allows for easier and faster laparoscopic suturing by eliminating repeated knots and the need to maintain tension on the suture line. Here we present the case of a small bowel obstruction caused by barbed suture used for vaginal cuff closure at the time of total laparoscopic hysterectomy. Implementation of a new technology or surgical material in laparoscopy to improve care must be optimized to prevent untoward events in our patients.