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Related Experiment Video

Updated: May 10, 2026

A Case Series of Successful Abdominal Closure Utilizing a Novel Technique Combining a Mechanical Closure System with a Biologic Xenograft that Accelerates Wound Healing
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Vaginal Cuff Complications After Closure with an Endoscopic Device versus Conventional Suturing.

Nicole Brzozowski1, Lily Deng2, Anya Laibangyang1

  • 1Department of Obstetrics, Gynecology and Reproductive Biology, Danbury Hospital, Danbury, CT. (Drs. Brzozowski, Laibangyang, Gill, Talari, Nolan, Wakefield, Doo, and Chuang).

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|January 20, 2025
PubMed
Summary

Endoscopic suturing devices did not significantly alter vaginal cuff complication rates compared to conventional laparoscopic instruments. However, increased cellulitis was observed with the endoscopic device, warranting further investigation in larger studies.

Keywords:
HysterectomyLaparoscopyVaginal cuff

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Laparoscopic suturing proficiency is critical for total laparoscopic hysterectomy.
  • Intracorporeal suturing presents challenges in needle control and tissue handling.
  • Endoscopic suturing devices aim to enhance the surgeon's experience.

Purpose of the Study:

  • To compare vaginal cuff complication rates between endoscopic device closure and conventional laparoscopic instrument closure.
  • To evaluate the safety and efficacy of endoscopic suturing devices in hysterectomy procedures.

Main Methods:

  • Retrospective cohort study (2018-2022) of 223 patients undergoing total laparoscopic hysterectomy.
  • Vaginal cuff closures were performed using either an endoscopic device (Endo Stitch) or conventional laparoscopic instruments.
  • Statistical analyses compared complication rates between the two groups.

Main Results:

  • Overall vaginal cuff complications occurred in 13% of patients (29/223).
  • A trend towards increased complications was noted with the Endo Stitch device (19.2% vs 11.4%), but not statistically significant (P=.16).
  • Significantly higher rates of cuff cellulitis were observed with Endo Stitch closure (8.5% vs 0%, P=.002).

Conclusions:

  • No significant difference in composite vaginal cuff complications was found between endoscopic and conventional laparoscopic methods.
  • The trend of increased complications and significantly higher cellulitis rates with endoscopic devices requires further study.
  • Both methods are considered appropriate, but larger, higher-powered studies are needed to confirm findings.