1.Vaginal Double Circular Incision-Closure Method: A New Technique for Vaginal Cuff Dehiscence after Total Laparoscopic Hysterectomy
Koji SHIMABUKURO ; Takanori YOSHIDA ; Tamami ODAI ; Takafumi TSUKADA ; Reiko NAKAMURA ; Ikuno YAMAUCHI ; Tatsuya SATO ; Haruka MANEYAMA ; Shiori KOHRI ; Yukiko NUSHI ; Yasuko NISHIDA ; Rie KITANO ; Asami HIRATA ; Maiko ICHIKAWA ; Seiichi ENDO ; Masae SAKAMOTO
Journal of the Japanese Association of Rural Medicine 2017;66(1):91-94
We report a case of vaginal cuff dehiscence after total laparoscopic hysterectomy that was successfully managed by a newly developed vaginal double-layer circular incision-closure method through a transvaginal approach. The nulligravid postmenopausal patient with cervical cancer received a diagnosis of vaginal evisceration on postoperative day 24. The eviscerated small intestine was pushed back after vaginal douching with normal saline before the procedure. The vaginal mucosa was incised circularly in two layers at the levels of 10 mm and 15 mm from the vaginal stump, and the edges apposed with double-layer closures. She was discharged on postoperative day 3 and followed up for 5 years, with no recurrence of cancer or vaginal dehiscence. This operative method is especially useful for a nulligravida with a small vagina.
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