Feasibility and Safety of Unidirectional Barbed Sutures in Laparoscopic OMGU: Initial Experience from a Single-Center Retrospective

Background: This study aimed to assess the short-term feasibility and safety of using unidirectional barbed sutures for the anastomosis during laparoscopic oral mucosal graft ureteroplasty (OMGU).

Methods: We retrospectively analyzed the data of all patients (n=10) who underwent OMGU using unidirectional barbed sutures at our institution between 2021 and 2025. Preoperative and postoperative clinical symptoms, imaging findings, perioperative data, and 36-Item Short Form Health Survey (SF-36) scores were collected and compared.

Results: A total of 10 patients were included. The median stricture length was 2.69 cm (range 2.33–8.66). The median operative time was 255 minutes (range 120–315), with a median anastomotic suturing time of 30 minutes. The median estimated intraoperative blood loss was 50 mL (range 30–200). No conversions to open surgery or intraoperative complications occurred. The median postoperative follow-up duration was 15.5 months (range 5–51), with an overall success rate of 90%. The postoperative complication rate was 40%, all of which were classified as Clavien-Dindo grade II. No patients were lost to follow-up.

Conclusion: In this small retrospective series, the use of unidirectional barbed sutures in laparoscopic OMGU appears to be feasible and associated with acceptable short-term safety and preliminary clinical outcomes. Larger, comparative studies with standardized endpoints are warranted to determine if barbed sutures offer measurable advantages over conventional suturing techniques.