Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies
Joint Authors
O'Hanlan, Katherine A.
Emeney, Pamela L.
Peters, Alfred
Sten, Margaret S.
McCutcheon, Stacey P.
Struck, Danielle M.
Hoang, Joseph K.
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-08-04
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Objective.
To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized.
Methods.
Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength.
Four outcomes are reviewed: dehiscence, bleeding, infection, and adhesions.
Results.
Of 1924 patients undergoing total laparoscopic hysterectomy, 44 patients (2.29%) experienced a vaginal cuff complication, with 19 (0.99%) requiring reoperation.
Five patients (0.26%) had dehiscence after sexual penetration on days 30–83, with 3 requiring reoperation.
Thirteen patients (0.68%) developed bleeding, with 9 (0.47%) requiring reoperation.
Twenty-three (1.20%) patients developed infections, with 4 (0.21%) requiring reoperation.
Three patients (0.16%) developed obstructive small bowel adhesions to the cuff requiring laparoscopic lysis.
Conclusion.
A running 5 mm deep × 5 mm apart culdotomy closure that incorporates the uterosacral ligaments with the pubocervical fascia, with reperitonealization when possible, appears to be associated with few postoperative vaginal cuff complications.
American Psychological Association (APA)
O'Hanlan, Katherine A.& Emeney, Pamela L.& Peters, Alfred& Sten, Margaret S.& McCutcheon, Stacey P.& Struck, Danielle M.…[et al.]. 2016. Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies. Minimally Invasive Surgery،Vol. 2016, no. 2016, pp.1-9.
https://search.emarefa.net/detail/BIM-1111342
Modern Language Association (MLA)
O'Hanlan, Katherine A.…[et al.]. Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies. Minimally Invasive Surgery No. 2016 (2016), pp.1-9.
https://search.emarefa.net/detail/BIM-1111342
American Medical Association (AMA)
O'Hanlan, Katherine A.& Emeney, Pamela L.& Peters, Alfred& Sten, Margaret S.& McCutcheon, Stacey P.& Struck, Danielle M.…[et al.]. Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies. Minimally Invasive Surgery. 2016. Vol. 2016, no. 2016, pp.1-9.
https://search.emarefa.net/detail/BIM-1111342
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1111342