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Vaginal cuff dehiscence: a randomized trial comparing robotic vaginal cuff closure methods

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Abstract

The purpose of this study is to compare the rate of vaginal cuff dehiscence between two different methods of closure in patients undergoing robotic-assisted total laparoscopic hysterectomy and explore variables related to postoperative breakdown. This was a prospective, randomized controlled study with two arms. The control group (Arm 1) underwent single-layer continuous closure while the study group (Arm 2) had three additional imbricating figure-of-X sutures placed in addition to the standard protocol. Of the 263 patients who completed the study, 4 patients (1.49 %) experienced dehiscence of the vaginal cuff. Three of the four patients with dehiscence received the standard single vaginal cuff closure (Arm 1) and the one remaining case of dehiscence underwent the protocol with additional sutures (Arm 2). All patients who experienced dehiscence were current smokers. Our study suggests that there may be benefit in adding additional sutures to the standard single-layer vaginal cuff closure procedure. Physicians should evaluate smoking status before deciding on a vaginal cuff closure method.

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Acknowledgments

We thank the surgeons and support staff at Sanford Medical Center for their participation in this study. We also want to express our gratitude to Dr. Peter Van Eerden for his computer-generated envelopes and to Stacy Wempe for her assistance in data collection.

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Authors and Affiliations

  1. Sanford USD Medical Center, 1400 W 22nd St, Sioux Falls, SD, 57105, USA

    Laurie B. Landeen

  2. Sanford School of Medicine of The University of South Dakota, Sioux Falls, SD, USA

    Laurie B. Landeen, Elizabeth M. Hultgren, Taylor M. Kapsch & Paul W. Mallory

Authors
  1. Laurie B. Landeen
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  2. Elizabeth M. Hultgren
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  3. Taylor M. Kapsch
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  4. Paul W. Mallory
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Corresponding author

Correspondence to Laurie B. Landeen.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

Laurie B. Landeen, M. D. declares that she owns stock with Intuitive Surgical (ISRG); Elizabeth M. Hultgren, Taylor M. Kapsch and Paul W. Mallory declare that they have no conflict of interest.

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Landeen, L.B., Hultgren, E.M., Kapsch, T.M. et al. Vaginal cuff dehiscence: a randomized trial comparing robotic vaginal cuff closure methods. J Robotic Surg 10, 337–341 (2016). https://doi.org/10.1007/s11701-016-0604-x

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  • DOI: https://doi.org/10.1007/s11701-016-0604-x

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