Vaginal cuff locsure techniques 2

초록

Vaginal cuff closure is a critical factor influencing postoperative outcomes after laparoscopic hysterectomy, particularly vaginal cuff dehiscence. This academic presentation reviews closure approaches, suturing techniques, suture materials, and single-port?specific technical considerations, integrating evidence from systematic reviews and randomized trials. Current data indicate higher dehiscence rates after laparoscopic and robotic hysterectomy than after abdominal hysterectomy, with smoking, infection, diabetes, steroid use, and radical surgery identified as risk factors. No clear advantage has been demonstrated for reinforced or double-layer closure over single-layer continuous suturing, nor between barbed and non-barbed sutures. Routine peritoneal closure does not reduce cuff-related complications. Optimal outcomes depend primarily on meticulous surgical technique rather than a single superior method, underscoring the need for further well-designed studies.