VAGINAL CUFF DEHISCENCE AFTER TOTAL LAPAROSCOPIC HYSTERECTOMY: PROSPECTIVE COMPARISON OF TWO TYPES OF SUTURING TECHNIQUES
AbstractBackground: To compare the frequency of vaginal cuff dehiscence after total laparoscopic hysterectomy between two different suturing techniques. Place and duration of study: The study was conducted at three centers; postgraduate tertiary care hospital, university affiliated hospital and private multidisciplinary hospital. The studied duration was from January 2019 to June 2020. Method: All patients with indication of total laparoscopic hysterectomy during the study period were included. These were randomly divided in to two groups A and B. Group A was performed upon the conventional interrupted figure of 8 vault suturing and group B with continuous, running, double layered suturing. Keeping the demographics almost same the frequency of a known but rare complication of vaginal cuff dehiscence (VCD) was determined. Results: A total of 195 patients were enrolled. Of these 87 were in group A and 108 in group B. The results were unequivocal as only one patient had the said complication. Conclusion: The morbid complication has no relation with the technique of vault suturing.
Cronin B, Sung VW, Matteson KA. Vaginal cuff dehiscence: risk factors and management. Am J Obstet Gynecol 2012;206(4):284–88.
Hur HC, Guido RS, Mansuria SM, Hacker MR, Sanfilippo JS, Lee TT. Incidence and patient characteristics of vaginal cuff dehiscence after different modes of hysterectomies. J Minim Invasive Gynecol 2007;14(3):311–7.
Fanning J, Kesterson J, Davies M, Green J, Penezic L, Vargas R, et al. Effects of electrosurgery and vaginal closure technique on postoperative vaginal cuff dehiscence. JSLS 2013;17(3):414–7.
Kho RM, Akl MN, Cornella JL, Magtibay PM, Wechter ME, Magrina JF. Incidence and characteristics of patients with vaginal cuff dehiscence after robotic procedures. Obstet Gynecol 2009;114(2 Pt 1):231–5.
Thyagaraju C, Modi R. Feasibility of total laparoscopic hysterectomy as a day care procedure. Int J Reprod Contracept Obstet Gynecol 2014;3(3):735–41.
Mittapalli R, Fanning J, Flora R, Fenton BW. Cost-effectiveness analysis of the treatment of large leiomyomas: laparoscopic assisted vaginal hysterectomy versus abdominal hysterectomy. Am J Obstet Gynecol 2007;196(5):e19–21.
Jeung IC, Baek JM, Park EK, Lee HN, Kim CJ, Park TC, et al. A prospective comparison of vaginal stump suturing techniques during total laparoscopic hysterectomy. Arch Gynecol Obstet 2010;282(6):631–8.
Uccella S, Ghezzi F, Mariani A, Cromi A, Bogani G, Serati M, et al. Vaginal cuff closure after minimally invasive hysterectomy: our experience and systematic review of the literature. Am J Obstet Gynecol 2011;205(2):119.e1–12.
Blikkendaal MD, Twijnstra AR, Pacquee SC, Rhemrev JP, Smeets MJ, de Kroon CD, et al. Vaginal cuff dehiscence in laparoscopic hysterectomy: influence of varying suturing methods of vaginal vault. Gynecol Surg 2012;9(4):39–400.
Siedhoff MT, Yunker AC, Steege JF. Decreased incidence of vaginal cuff dehiscence after laparoscopic closure with bidirectional barbed suture. J Minim Invasive Gynecol 2011;18(2)218–23.
Einarsson JI, Vellinga TT, Twijnstra AR, Chavan NR, Suzuki Y, Greenberg JA. Bidirectional
barbed suture: an evaluation of safety and clinical outcomes. JSLS 2010;14(3):381–5.
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