Laparoscopic Versus Vaginal Cuff Closure During Laparoscopic Hysterectomy in Benign Gynecological Lesions | ||
| Evidence Based Women's Health Journal | ||
| Volume 15, Issue 15, January 2025, Pages 1-9 PDF (514.12 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ebwhj.2024.316049.1355 | ||
| Authors | ||
| ahmed mahmoud elashry* 1; H M Youssef2; Maged Rageb Elshamy2; Mohamed Sayed Abdelhafez2; Mahmoud Mohamed Awad2 | ||
| 1department of obstetrics and gynecology , Mansoura universuty ,Egypt | ||
| 2Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||
| Abstract | ||
| Objective: To compare endoscopic Bakay technique with transvaginal suturing technique for vaginal cuff closure in total laparoscopic hysterectomy (TLH). Patients and Methods: Randomized study conducted on women who were planned to undergo TLH for benign gynecological lesion. All participants were randomly allocated into 2 groups; 1) Bakay group, in which vaginal cuff was closed by endoscopic Bakay technique, and 2) transvaginal group, in which vaginal cuff was closed by transvaginal suturing technique. Primary outcome measure was estimated amount of blood loss, and secondary outcome measures were operative time (including vaginal cuff closure time), preoperative and postoperative vaginal length, and intraoperative and postoperative complications. Results: A total of 40 women (20 per group) were subjected to final analysis. Estimated amount of blood loss was lower in Bakay than in transvaginal group but without significant difference (P = 0.080). Total operative time was significantly shorter in transvaginal than in Bakay group (47.80 ± 6.0 vs 55.10 ± 9.6 min; P = 0.007). This was mainly attributed to highly significantly longer vaginal cuff closure time in Bakay than in transvaginal group (15.20 ± 4.3 vs 6.87 ± 0.8 min; P < 0.001). Postoperative vaginal length was highly significantly preserved in Bakay group (P = 0.001). No recorded major complications in both groups. Conclusion: Use of Bakay technique for vaginal cuff closure during TLH is generally safe, and ensures better vaginal length preservation, less intraoperative blood loss and better vaginal cuff support, however; it requires advanced surgical skills to shorten the operation time. | ||
| Keywords | ||
| Bakay technique; cuff closure; laparoscopic hysterectomy; TLH | ||
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