Laparscopic versus transvaginal closure of vaginal cuff in patients undergoing total laparoscopic hysterectomy: A randomized study

Abstract

Background: The surgical procedure known as hysterectomy is widely recognized as the prevailing gynecological intervention worldwide, particularly in cases with non-malignant diseases. The purpose of this study was to contrast between closure of vaginal cuff after total laparoscopic hysterectomy (TLH) trans-laparoscopic or through vaginal approach.Methods: This prospective simple randomized controlled study was carried out on 80 women aged from 45to 65years old and body mass index<35 with benign lesions like multiple fibroids, endometrial hyperplasia and adenomyosis. Patients were divided into two equal groups underwent TLH with vaginal cuff closure through intracorporeal laparoscopic suture using vicryl 1 in Group I (Intracorporeal closure) and. vaginal route using vicryl 1 in Group II (Transvaginal closure).Results: Logistic regression with odds ratios (OR) and 95% confidence intervals (CI) predicting post-operative complications. OR of BMI was 1.187, and the CI ranged from 1.009 to 1.396 (P= 0.039). Logistic regression with OR and 95% CI predicting any cuff complication. OR of Age was 0.648, and the CI ranged from 0.482 to 0.871 (P= 0.004). OR of diabetes was 36.500, and the CI ranged from 2.703 to 492.862 (P= 0.007). Conclusions: Intracorporeal laparoscopic closure of vaginal cuff is better than vaginal closure during TLH.