Cuff Closure by Vaginal Route in TLH:
Case Series and Review of Literature
Published: March 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/25056.9447
Huseyin Aydogmus, Serpil Aydogmus, Servet Gençdal, Sefa kelekçi
1. Lecturer, Department of Obstetrics and Gynaecology, Izmir Katip Çelebi University, Atatürk Research and Training Hospital, Izmir, Narlidere, Turkey.
2. Associate Professor, Department of Obstetrics and Gynaecology, Izmir Katip Çelebi University, Atatürk Research and Training Hospital, Izmir, Narlidere, Turkey.
3. Lecturer, Department of Obstetrics and Gynaecology, Izmir Katip Çelebi University, Atatürk Research and Training Hospital, Izmir, Narlidere, Turkey.
4. Professor, Department of Obstetrics and Gynaecology, Izmir Katip Çelebi University, School of Medicine, Izmir, Karabaglar, Turkey.
Correspondence
Dr. Serpil Aydogmus,
ilica Mah, Zeytin Sok, No20/20, 35320, Narlidere, Izmir, Turkey,
E-mail: serpilaydogmus@gmail.com
Total Laparoscopic Hysterectomy (TLH) represents one of the most performed gynaecological procedures nowadays. The closure of the vaginal cuff is the most diffucult part of TLH because of the difficulty of laparoscopic suturing techniques. Our aim was to evaluate the efficacy and safety of vaginal cuff closure by vaginal route on patients submitted to TLH. During the period between January 2013 to December 2015 total number of 64 laparoscopic hysterectomy were performed in our clinic. TLH and vaginal vault closure was performed as described by Ghezzi for all patients. The length of cuff closure time and the frequency of vaginal cuff-related complications were measured. Mean age was 48.1 (38-71) years, mean parity was 2.6 (1-9). Most ranked indications for hysterectomy were abnormal uterine bleeding and symptomatic leiomyoma. Average cuff closure time was 6 (2-17) minute. In average 24 (2-36) month followup there were no vaginal vault dehiscence. Transvaginal vaginal cuff closure seems to be safe, easy and effective for total vaginal hysterectomy. Using vaginal route can significantly reduce the length of closure time. This technique has comparable complication rates with endoscopic suturing techniques.
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