LAS VEGAS - The risk of vaginal cuff
complications was not influenced by the type of hysterectomy performed, although suture technique was a factor, in a retrospective analysis of 604 patients.
(8) If bacterial vaginosis is present, treatment prior to surgery can reduce the frequency of vaginal cuff
Some surgeons are now using barbed suture to close the vaginal cuff
in a double-layer closure, but I have continued using figure-of-eight sutures of PDS.
In general, each step of the single-port procedure has been found to be equivalent in time to a multiport approach to robotic-assisted hysterectomy--except for the step of vaginal cuff
"Pain scores, vaginal cuff
complications, length of hospital stay, and readmission rates within 30 days were also similar," Dr.
Although many women in the series had concurrent procedures, researchers focused only on the hysterectomy portion of surgery from incision of the mucosa to the close of the vaginal cuff
Because of this, fistulas stemming from benign gynecologic surgical activity tend to occur above the trigone near the vaginal cuff
The caveat is that the 94 women who underwent robotic-assisted laparo-scopic hysterectomy experienced unique adverse events: four vaginal cuff
infections and two vaginal cuff
More operative and postoperative complications were seen in the TLH group (vaginal cuff
bleeding requiring return to the operating room, 2 patients; cuff cellulitis, 1; intraoperative vaginal laceration, 1; urinary tract infection, 1), although the difference did not reach statistical significance.
At the end of the anterior repair, the apical sutures are then incorporated into the vaginal cuff
. Regardless of the type of transvaginal suspension, it is beneficial to bring one arm of the suspension suture through the anterior wall of the cuff and the other arm through the posterior cuff.
What does the raw surface of the posterior vaginal cuff
"heal to" or granulate to when absorbable sutures are used, to allow it to be a permanent fix?
The vaginal cuff
can be closed intracorporeally using one conventional needle driver and one reticulating grasper, but it can also be facilitated with a commercial suturing device and extracorporeal knot tying.