{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:20:41Z","timestamp":1790011241831,"version":"4.0.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intracorporeal suturing knots continue to be one of the most challenging and time-consuming steps in the thoracoscopic repair of congenital diaphragmatic hernia (CDH). Barbed unidirectional knotless sutures are designed to shorten surgical procedures by eliminating the need to tie knots. This work aimed to compare unidirectional barbed sutures and interrupted intracorporeal knots in the thoracoscopic repair of CDH in pediatrics regarding the time required to suture, operative time and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 139 patients presented with Bochdalek CDH. Patients were classified into early (neonatal) and late presentations. The hernia defect was repaired by unidirectional <jats:bold>B<\/jats:bold>arbed sutures (V-Loc<jats:sup>TM<\/jats:sup> and Stratafix<jats:sup>TM<\/jats:sup> sutures) in group <jats:bold>B<\/jats:bold> or by <jats:bold>C<\/jats:bold>onventional interrupted intracorporeal knots in group <jats:bold>C<\/jats:bold>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In both early and delayed presentations, the time required to suture (15 and 13\u2005min in group B, 33 and 28\u2005min in group C for neonatal and delayed presentation respectively) was significantly shorter in group B. Complications (visceral perforation, wound infection, and recurrence) insignificantly differed between group B and group C of early presentation. No patients suffered from major complications in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both unidirectional barbed sutures and intracorporeal knots were safe and effective. However, unidirectional barbed sutures are a time-saving choices for CDH thoracoscopic repair in early and late presentations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1348753","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T04:32:16Z","timestamp":1705552336000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Unidirectional barbed sutures vs. interrupted intracorporeal knots in thoracoscopic repair of congenital diaphragmatic hernia in pediatrics"],"prefix":"10.3389","volume":"12","author":[{"given":"Mohamed Ali","family":"Shehata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ahmed","family":"Negm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Mahmoud","family":"Shalaby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Awad","family":"Mansour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Abdelmhaimen","family":"Elhaddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s00383-022-05303-y","article-title":"Minimal access surgery for congenital diaphragmatic hernia: surgical tricks to facilitate anchoring the patches to the ribs","volume":"39","author":"Mansour","year":"2023","journal-title":"Pediatr Surg Int"},{"key":"B2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3390\/children10010067","article-title":"Lifesaving treatments for the tiniest patients\u2014a narrative description of old and new minimally invasive approaches in the arena of fetal surgery","volume":"10","author":"Kohl","year":"2023","journal-title":"Children"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1016\/S0022-3468(03)00564-5","article-title":"Early experience with minimally invasive repair of congenital diaphragmatic hernias: results and lessons learned","volume":"38","author":"Arca","year":"2003","journal-title":"J Pediatr Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1016\/j.jpedsurg.2010.02.017","article-title":"Thoracoscopic repair in congenital diaphragmatic hernia: patching is safe and reduces the recurrence rate","volume":"45","author":"Keijzer","year":"2010","journal-title":"J Pediatr Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.jpedsurg.2010.08.062","article-title":"Does thoracoscopic congenital diaphragmatic hernia repair cause a significant intraoperative acidosis when compared to an open abdominal approach?","volume":"46","author":"Fishman","year":"2011","journal-title":"J Pediatr Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1227\/ons.0000000000000158","article-title":"Endoscopic endonasal eustachian tube obliteration for cerebrospinal fluid rhinorrhea: a case series and scoping review","volume":"22","author":"Rimmer","year":"2022","journal-title":"Oper Neurosurg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"4","DOI":"10.2174\/1573404813666170203151737","article-title":"Current innovations in laparoscopy","volume":"14","author":"Siedhoff","year":"2018","journal-title":"Curr Women\u2019s Health Rev"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1089\/end.2010.0200","article-title":"A novel method of urethrovesical anastomosis during robot-assisted radical prostatectomy using a unidirectional barbed wound closure device: feasibility study and early outcomes in 51 patients","volume":"24","author":"Kaul","year":"2010","journal-title":"J Endourol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1159\/000488241","article-title":"What is the role of barbed suture in laparoscopic myomectomy? 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