The purpose of this study is to see if two-layer laparoscopic vaginal cuff closure during laparoscopic hysterectomy is linked with a reduced risk of postoperative problems than a normal one-layer cuff closure. Between 2011 and 2017, a retrospective cohort analysis of total laparoscopic hysterectomies done by fellowship-trained minimally invasive gynecologic surgeons was conducted. The vaginal cuff was sutured laparoscopically, either in a two- or one-layer closure. The primary outcome was a composite of total postoperative problems within 30 days, including all medical and surgical difficulties and vaginal cuff issues within 180 days. Age, postmenopausal status, body mass index, cigarette usage, and immunosuppressant medicines were investigated and adjusted for, but surgeon skill, colpotomy method, and suture material remained consistent. Researchers carried out statistical analyses such as the 2, Fisher exact test, logistic regression, and post hoc power estimations. The vaginal cuffs of 40.8 percent of the 2,973 women who had complete laparoscopic hysterectomies were closed with a two-layer method and 59.2 percent with a one-layer technique. The use of a two-layer vaginal cuff was linked with a lower number of overall postoperative problems. The main difference was reduced vaginal cuff problems within 180 days; there were no variations in 30-day medical and surgical postoperative complications between the two groups. The two-layer vaginal cuff closure cohort had no vaginal cuff dehiscence or mucosal separation, whereas the one-layer group had 1.0 percent. A two-layer closure was found to be more protective against postoperative problems than a one-layer closure.
Although postoperative problems from laparoscopic hysterectomies are uncommon, two-layer laparoscopic vaginal cuff closure is linked with fewer overall postoperative difficulties than one-layer closure.
