Continuous versus Interrupted Cuff Closure in Laparoscopic Hysterectomy

Abstract

Background: When compared to abdominal and vaginal hysterectomy, total laparoscopic hysterectomy (TLH) is associated with a higher incidence of vaginal cuff dehiscence (VCD), a serious adverse event and occurs regarding to suture techniques so we compare between interrupted and continuous suture for vaginal cuff closure during TLH. Aim: To evaluate whether the use of continuous sutures for vaginal cuff closure during TLH reduced the surgical difficulty, suturing time and adverse events when compared to interrupted suture. Methods: This comparative study was conducted on 50 patients diagnosed with benign gynecological conditions with failed medical management or not amenable to medical management, they underwent total laparoscopic hysterectomy. Patients were divided randomly into two groups: group I: 25 patients who underwent total laparoscopic hysterectomyand using continuous running suture and group II: 25 patients who underwent total laparoscopic hysterectomyand using interrupted suture. Results: There was significant difference between both groups regarding to suturing time that was higher in interrupted group than continuous group. There was significant difference between both groups regarding to degree of surgical difficulty using VAS that was longer in interrupted group than continuous group. Conclusion: Continuous suture approach was safe, effective and well tolerated procedure that reduces operative times, suturing time and degree of surgical difficulty for TLH more than interrupted suture.