Abstract
Discussion Forum (0)
Introduction: While the implementation of robotic surgery has improved many postoperative outcomes, an increased rate of vaginal cuff dehiscence (VCD) has been observed in colpotomy closures performed robotically compared to transvaginal or laparoscopic closures. No consensus exists for suture interval or depth of tissue in intracorporal vaginal cuff closure. A study published by O'Hanlan et al. (Minimally Invasive Surgery, 2016) proposes a suture interval and depth of 5 mm. Our study aims to assess if there is any advantage for decreasing postoperative complications with an alternative closure technique.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Introduction: While the implementation of robotic surgery has improved many postoperative outcomes, an increased rate of vaginal cuff dehiscence (VCD) has been observed in colpotomy closures performed robotically compared to transvaginal or laparoscopic closures. No consensus exists for suture interval or depth of tissue in intracorporal vaginal cuff closure. A study published by O'Hanlan et al. (Minimally Invasive Surgery, 2016) proposes a suture interval and depth of 5 mm. Our study aims to assess if there is any advantage for decreasing postoperative complications with an alternative closure technique.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Robotic-Assisted Vaginal Cuff Closure Technique and Vaginal Cuff Dehiscence Rates
Dr. Shayna Burdeaux
Abstract
Discussion Forum (0)
Introduction: While the implementation of robotic surgery has improved many postoperative outcomes, an increased rate of vaginal cuff dehiscence (VCD) has been observed in colpotomy closures performed robotically compared to transvaginal or laparoscopic closures. No consensus exists for suture interval or depth of tissue in intracorporal vaginal cuff closure. A study published by O'Hanlan et al. (Minimally Invasive Surgery, 2016) proposes a suture interval and depth of 5 mm. Our study aims to assess if there is any advantage for decreasing postoperative complications with an alternative closure technique.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Introduction: While the implementation of robotic surgery has improved many postoperative outcomes, an increased rate of vaginal cuff dehiscence (VCD) has been observed in colpotomy closures performed robotically compared to transvaginal or laparoscopic closures. No consensus exists for suture interval or depth of tissue in intracorporal vaginal cuff closure. A study published by O'Hanlan et al. (Minimally Invasive Surgery, 2016) proposes a suture interval and depth of 5 mm. Our study aims to assess if there is any advantage for decreasing postoperative complications with an alternative closure technique.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
Methods: This is a descriptive study of post-operative outcomes at our institution that was conducted via a retrospective chart review. Instances of complications including infection, reoperation and VCD rates were recorded for robotic-assisted laparoscopic hysterectomies and trachelectomies performed between 2016-2017. Robotic vaginal cuff closure was performed using V-Loc 90 suture with suture interval and depth of 10 mm. These outcome rates were compared to the complication rates published by O'Hanlan et al. IRB approval was obtained.
Results: 160 patients were included in Group 1. An overall complication rate of 11.9% was noted in our study which included infection, VCD, bleeding and re-operation rates. A 2.5% VCD rate was observed with 1.25% of patient's requiring re-operation. Postoperative infection rate in Group 1 was 3.1%.
Conclusion/Implications: No significant benefit was demonstrated in patients who underwent robotic-assisted vaginal cuff closure with a suture interval and depth of 10 mm compared to previously published data by O'Hanlan et al using a closure interval and depth of 5 mm.
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