Strategies to Prevent Vaginal Vault Descent during Hysterectomy

Laparoscopic Hysterectomy and Prolapse: A Multiprocedural Concept

“…A disadvantage is the unification of the 2 lateral sutures in the midline, which results in an unphysiological narrowing of the apical pole of the vagina. The transposition of the ureters carries the risk of kinking and therefore the suture modified by van Herendael, 23 which circumvents this risk, should be applied.…”

“…22,23 After cautious coagulation of the vaginal edge, 24 suturing of the vagina can begin. To avoid postoperative necrotic areas of the vaginal stump, coagulation is carried out very cautiously.…”

“…The suture technique of Te Linde, known from abdominal hysterectomy, for the closure of the vagina has been modified by Bruno van Herendael to be used laparoscopically. 22 , 23 After cautious coagulation of the vaginal edge, 24 suturing of the vagina can begin. To avoid postoperative necrotic areas of the vaginal stump, coagulation is carried out very cautiously.…”

Factors to Consider in Gynecological Surgery

“…Optionally, both sacrouterine ligaments may be attached to the posterior vaginal wall to prevent vaginal prolapse (McCall culdoplasty; Figure 14) [13,14]. Vaginal cuff dehiscence must be avoided [15].…”