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Single-layer versus double-layer closure of the vaginal cuff with barbed sutures in laparoscopic hysterectomy
Affiliations- Department of Obstetrics and Gynecology, Saglik Bilimleri University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Türkiye
- Department of Obstetrics and Gynecology, Saglik Bilimleri University, Bagcilar Training and Research Hospital, Istanbul, Türkiye
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Abstract
Objectives: The utilization of barbed sutures in laparoscopic hysterectomy has become popular among gynecologic surgeons. Our aim was to compare the outcomes of two different techniques for closing the vaginal cuff with barbed sutures in laparoscopic hysterectomies. Material and methods: A retrospective study was completed on 202 patients who underwent laparoscopic hysterectomy for benign diseases at Istanbul Kanuni Sultan Suleyman Training and Research Hospital from April 2014 through June 2016. In group 1 (n = 139), a single-layer continuous suturing method was used; each bite contained the pubocervical fascia and vaginal mucosa anteriorly, and vaginal mucosa and rectovaginal fascia posteriorly. In group 2 (n = 63), a double-layer continuous suturing method was used; only vaginal mucosa was included in the first layer, and a second layer incorporated the pubocervical and rectovaginal fascias. Results: Patient characteristics (age, body mass index, parity, previous abdominal surgery, smoking, comorbidity) were similar between the two groups. There were also no differences in total operation time, length of hospitalization, intraoperative complications, and perioperative change in hemoglobin levels. There was no difference between the two groups in terms of vaginal cuff dehiscence, which was the primary outcome measure of the study. Secondary outcome measures (presence of granulation tissue, spotting, cuff cellulitis) were also similar between the two groups. Conclusions: We observed no differences in outcomes between single- or double-layer vaginal closure techniques with barbed sutures.
Abstract
Objectives: The utilization of barbed sutures in laparoscopic hysterectomy has become popular among gynecologic surgeons. Our aim was to compare the outcomes of two different techniques for closing the vaginal cuff with barbed sutures in laparoscopic hysterectomies. Material and methods: A retrospective study was completed on 202 patients who underwent laparoscopic hysterectomy for benign diseases at Istanbul Kanuni Sultan Suleyman Training and Research Hospital from April 2014 through June 2016. In group 1 (n = 139), a single-layer continuous suturing method was used; each bite contained the pubocervical fascia and vaginal mucosa anteriorly, and vaginal mucosa and rectovaginal fascia posteriorly. In group 2 (n = 63), a double-layer continuous suturing method was used; only vaginal mucosa was included in the first layer, and a second layer incorporated the pubocervical and rectovaginal fascias. Results: Patient characteristics (age, body mass index, parity, previous abdominal surgery, smoking, comorbidity) were similar between the two groups. There were also no differences in total operation time, length of hospitalization, intraoperative complications, and perioperative change in hemoglobin levels. There was no difference between the two groups in terms of vaginal cuff dehiscence, which was the primary outcome measure of the study. Secondary outcome measures (presence of granulation tissue, spotting, cuff cellulitis) were also similar between the two groups. Conclusions: We observed no differences in outcomes between single- or double-layer vaginal closure techniques with barbed sutures.
Keywords
barbed suture, vaginal cuff dehiscence, laparoscopic hysterectomy, closure technique
About this articleTitle
Single-layer versus double-layer closure of the vaginal cuff with barbed sutures in laparoscopic hysterectomy
Journal
Issue
Article type
Research paper
Pages
229-234
Published online
2018-05-30
Page views
1942
Article views/downloads
2231
DOI
Pubmed
Bibliographic record
Ginekol Pol 2018;89(5):229-234.
Keywords
barbed suture
vaginal cuff dehiscence
laparoscopic hysterectomy
closure technique
Authors
Dogukan Yildirim
Sefik Eser Ozyurek
Huseyin Kiyak
Agahan Han
Nadiye Koroglu
Aysegul Bestel
Fitnat Topbas
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