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.Aim of the study: To compare port site skin suturing versus tissue adhesive (n-butyl -2- cynoacrylate) in laparoscopic surgery OBJECTIVES OF STUDY: 1. To assess the incidence of surgical site infection in both the groups 2. To compare the time required for port closure in both the groups 3. To evaluate the wound pain among the two groups 4. To evaluate surgeon?s satisfaction of the suture & tissue adhesive 5. To compare post operative complications in both the groups 6. To compare the cosmetic outcome in both the groups 7. To evaluate safety of suture & tissue adhesive MATERIALS AND METHODS This is a prospective study will be conducted in the Department of Obstetrics and Gynecology, Sri Adichunchunagiri Hospital and Research Center B.G. Nagara Source ? In-Patients admitted for laparoscopic surgery Study Duration: 6 months Study Design: prospective comparative study Blinding - single blinding Sample Size: 60 METHODOLOGY: After obtaining clearance from Institutional ethical committee, the study will be conducted in patients who give written informed consent. . Randomization will be performed by lottery methods, patients assigned to port-site tissue adhesives or port-site suturing group respectively. Matching was done for diabetes mellitus, BMI, hypertension and dyslipidemia for both inclusion and exclusion criteria. Results 1. Demographics and Baseline Characteristics A total of 60 patients were enrolled in the study, with 30 patients assigned to the Tissue Adhesive Group (Group A) and 30 patients assigned to the Suture Group (Group B). The baseline characteristics were well-matched between the two groups in terms of age, BMI, diabetes, hypertension, and other co-morbidities (Table 1). ? Age (mean ? SD): ? Group A: 45.6 ? 7.1 years ? Group B: 46.2 ? 6.8 years ? BMI (mean ? SD): ? Group A: 28.3 ? 3.4 kg/m? ? Group B: 28.5 ? 3.5 kg/m? ? Diabetes Mellitus: ? Group A: 6 (20%) ? Group B: 5 (16.7%) ? Hypertension: ? Group A: 5 (16.7%) ? Group B: 6 (20%) 2. Incidence of Surgical Site Infection (SSI) The incidence of SSI was similar between the two groups. ? Group A (Tissue Adhesive): 2 (6.7%) patients developed SSI. ? Group B (Suture): 3 (10%) patients developed SSI. 3. Time Required for Port Closure The mean time for port closure was similar between the two groups. ? Group A (Tissue Adhesive): 4.8 ? 0.7 minutes ? Group B (Suture): 5.3 ? 1.1 minutes 4. Wound Pain (VAS Score) Both groups reported similar pain levels at various time points. ? Day 0 (post-surgery): ? Group A: 3.0 ? 1.2 ? Group B: 3.2 ? 1.1 ? Day 10 (?2): ? Group A: 1.2 ? 0.7 ? Group B: 1.3 ? 0.8 ? Day 30 (?7): ? Group A: 0.4 ? 0.3 ? Group B: 0.5 ? 0.4 5. Surgeon Satisfaction (Product Usage Assessment Scale) Surgeon satisfaction was comparable between the two groups. ? Group A (Tissue Adhesive): 4.1 ? 0.6 (Good) ? Group B (Suture): 4.0 ? 0.7 (Good) ? 6. Post-operative Complications Both groups had similar rates of post-operative complications. ? Group A (Tissue Adhesive): ? 1 (3.3%) case of minor hematoma, resolved with conservative management. ? No wound gaping or bleeding complications. ? Group B (Suture): ? 1 (3.3%) case of minor hematoma, resolved with conservative management. ? No wound gaping or bleeding complications. 7. Cosmetic Outcome (Modified Hollander Wound Score) The cosmetic outcomes were similar between the two groups. ? Group A (Tissue Adhesive): 8.9 ? 0.9 (Good) ? Group B (Suture): 8.7 ? 1.1 (Good) 8. Adverse Events ? Group A (Tissue Adhesive): No significant adverse events or allergic reactions to the adhesive were reported. ? Group B (Suture): 1 (3.3%) case of mild allergic reaction to suture material, managed with antihistamines. Conclusion This study demonstrates that tissue adhesive and suture techniques for laparoscopic port-site closure yield comparable results in terms of infection rates, time to closure, pain levels, cosmetic outcomes, and surgeon satisfaction. No significant differences were found between the two methods, suggesting that tissue adhesive can be an alternative to suturing with similar outcomes.