Vaginal cuff dehiscence after robotic total laparoscopic hysterectomy.
BACKGROUND
Vaginal cuff dehiscence with small bowel evisceration after hysterectomy is a rare event that may be occurring more frequently with the advent of robotic laparoscopic hysterectomies.


METHODS
Two women underwent robotic total laparoscopic hysterectomy for menorrhagia and stage I endocervical adenocarcinoma, respectively. Each presented 7-8 weeks postoperatively with abdominal pain and vaginal pressure after intercourse. The small bowel protruded into the vagina through the dehisced vaginal cuff. Both cuffs were repaired vaginally with delayed absorbable suture. One repair required revision 7 weeks after the initial repair.


CONCLUSIONS
Robotic total laparoscopic hysterectomy may be associated with increased risk of vaginal cuff dehiscence and small bowel evisceration. This observation may be because of thermal spread and cuff tissue damage from electrosurgery used for colpotomy.
Robinson
Barbara L
BL
From the Department of Obstetrics and Gynecology, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104.
Liao
John B
JB
Adams
Sarah F
SF
Randall
Thomas C
TC
D000230:Adenocarcinoma / Q000601:surgery; D004630:Emergencies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008595:Menorrhagia / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D012371:Robotics; D013529:Surgical Wound Dehiscence; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014621:Vagina / Q000601:surgery*