Dramatically reduced incidence of vaginal cuff dehiscence in gynecologic patients undergoing endoscopic closure with barbed sutures: A retrospective cohort study

Abstract

Vaginal cuff separation subsequent to laparoscopic closure is a rare occurrence. While our incidence of VCD was low and comparable to other reported rates in the literature, we did not observe any cases of VCD following laparoscopic hysterectomy performed with barbed suture closure.

Unidirectional barbed suture for vaginal cuff closure without backward stitch in total laparoscopic hysterectomy

“…In the laparoscopic surgery arm (n = 483), vaginal cuff closure was performed with unidirectional or bidirectional barbed suture in 427 patients and cuff dehiscence was not reported in any of these cases. 26 In our study, we observed VCD in three patients (1.8%). Two of them were occurred at 75th and 122th days of surgery.…”

“…Of note, both were associated with sexual intercourse. Sexual intercourse is accepted as a risk factor for developing cuff dehiscence that has been previously published literature . However, cuff dehiscence had occurred 6th weeks after surgery and it seems that is not justified to attribute the VCD, solely to be sexual intercourse.…”

“…analyzed the rate of VCD in 1876 patients who underwent either laparoscopic or robotic‐assisted hysterectomy. In the laparoscopic surgery arm ( n = 483), vaginal cuff closure was performed with unidirectional or bidirectional barbed suture in 427 patients and cuff dehiscence was not reported in any of these cases …”

Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure

“…[20,21] Other studies indicate that the use of barbed sutures decreases the incidence of vaginal cuff dehiscence. [14,22–24] …”

Laparoscopic hysterectomy; our experience

“…Rettenmaier ve ark. (20) çalışmalarında, barbed sütur ile kubbe süturasyonu sonrası dehisens riskinin daha az olduğunu bildirmiş-lerdir. Bu çalışmadaki hastalarda vajinal kubbe no:1 polyglactyn 910 ile kontinyu süture edilmiş ve hiçbir hastada vajinal kubbe dehisensi saptanmamıştır.…”