Comparison Of Outcomes Of Vaginal Cuff Closure Versus Laparoscopic Cuff Closure In Total Laparoscopic Hysterectomy In Perimenopausal Women

Hysterectomy is the most common surgical intervention on the female genital tract following

cesarean delivery. Suturing the vaginal cuff is the last stage of TLH. A variety of procedures are available,

depending on the surgeon preference. It is possible to execute interrupted or continuous

suturing, transvaginal cuff closure, and laparoscopic suturing. Due to the complexity of

laparoscopic suturing procedures, the closure of the vaginal cuff is the most challenging

aspect.

Significant drawbacks like cuff dehiscence, intestinal injury, vault bleeding, cuff infection

etc. of the procedure include the need for sophisticated surgical skills, a lengthy learning

curve, and a time-consuming procedure.

In a total of 16 patients undergoing TLH at OBGY department of AVBRH, they will

be simply randomized in a 1:1 ratio to have either laparoscopic or transvaginal closure

of the vaginal cuff, and patients will be kept in the dark about the manner of closure.

Post op cuff-related complications will be followed up after 1 and 2 month

postoperative period like partial cuff disruption, dehiscence, granulation, cuff

infection and yellowish vaginal discharge and will be analyzed.

The present study is also of value for providing new insight in the possible risk

factors for vaginal dehiscence and vaginal cuff complications, because etiological

studies and theories have not yet been supported by substantial evidence.

There is an ongoing need to study the superiority of one vaginal vault suturing

technique over another as the available data is limited.