Mark A Rettenmaier1, Lisa N Abaid1, John V Brown1, Alberto A Mendivil1, Katrina L Lopez2, Bram H Goldstein3. 1. Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, United States. 2. Nancy Yeary Women's Cancer Research Foundation, Newport Beach, CA 92663, United States. 3. Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, United States. Electronic address: bram@gynoncology.com.
Abstract
INTRODUCTION: This retrospective study documented the rate of vaginal cuff dehiscence (VCD) in a large series of gynecologic patients who were treated with an endoscopic (robotic-assisted or laparoscopic) hysterectomy that incorporated either delayed absorbable monofilament barbed or vicryl running sutures. METHOD: We sought to discern any prognostic associations between operative variables (e.g., closure type (barbed or vicryl sutures), endoscopic approach (robotic-assisted or laparoscopic), and energy source (Harmonic Ace Shears or monopolar/bipolar electro-surgery)) and the risk for VCD via patient chart review. Statistical evaluation was comprised of univariate analyses and multiple regression. RESULTS: We identified 1876 subjects; there were 14 cases (0% with barbed suture and 0.99% with vicryl suture) of VCD (an overall incidence of 0.75%), nearly all of which were associated with a robotic-assisted hysterectomy involving vicryl sutures (p = 0.034). However, the type of endoscopic surgery (P = 0.11) and energy source (P = 0.28) were not significant prognostic factors. The VCD patients' exhibited a median duration of 47 days (range, 14-116) until the development of their condition. CONCLUSION: Vaginal cuff separation subsequent to laparoscopic closure is a rare occurrence. While our incidence of VCD was low and comparable to other reported rates in the literature, we did not observe any cases of VCD following laparoscopic hysterectomy performed with barbed suture closure.
INTRODUCTION: This retrospective study documented the rate of vaginal cuff dehiscence (VCD) in a large series of gynecologic patients who were treated with an endoscopic (robotic-assisted or laparoscopic) hysterectomy that incorporated either delayed absorbable monofilament barbed or vicryl running sutures. METHOD: We sought to discern any prognostic associations between operative variables (e.g., closure type (barbed or vicryl sutures), endoscopic approach (robotic-assisted or laparoscopic), and energy source (Harmonic Ace Shears or monopolar/bipolar electro-surgery)) and the risk for VCD via patient chart review. Statistical evaluation was comprised of univariate analyses and multiple regression. RESULTS: We identified 1876 subjects; there were 14 cases (0% with barbed suture and 0.99% with vicryl suture) of VCD (an overall incidence of 0.75%), nearly all of which were associated with a robotic-assisted hysterectomy involving vicryl sutures (p = 0.034). However, the type of endoscopic surgery (P = 0.11) and energy source (P = 0.28) were not significant prognostic factors. The VCD patients' exhibited a median duration of 47 days (range, 14-116) until the development of their condition. CONCLUSION: Vaginal cuff separation subsequent to laparoscopic closure is a rare occurrence. While our incidence of VCD was low and comparable to other reported rates in the literature, we did not observe any cases of VCD following laparoscopic hysterectomy performed with barbed suture closure.
Authors: Julia Caroline Radosa; Marc Philipp Radosa; Julia Sarah Maria Zimmermann; Eva-Marie Braun; Sebastian Findeklee; Annette Wieczorek; Lisa Stotz; Amr Hamza; Ferenc Zoltan Takacs; Uda Mareke Risius; Christoph Gerlinger; Christoph Georg Radosa; Stefan Wagenpfeil; Erich-Franz Solomayer Journal: Arch Gynecol Obstet Date: 2021-05-03 Impact factor: 2.493
Authors: Jin Hwi Kim; Seung Won Byun; Jae Yeon Song; Yeon Hee Kim; Hee Joong Lee; Tae Chul Park; Keun Ho Lee; Soo Young Hur; Jong Sup Park; Sung Jong Lee Journal: Medicine (Baltimore) Date: 2016-09 Impact factor: 1.889