Vault Closure

Vault closure in total laparoscopic hysterectomy (TLH) is a critical step aimed at preventing complications such as vault dehiscence. This chapter provides a comprehensive overview of the various techniques and considerations involved in vault closure. The chapter discusses the importance of proper closure methods to ensure patient safety and support. It covers suturing techniques, choice of materials, support and strength provided, risk management, and postoperative care. The debate surrounding different closure methods, including continuous, interrupted, and running-locking sutures, is examined. Use of barbed sutures and their potential advantages and disadvantages have been highlighted. The chapter highlights the need for larger clinical trials to definitively establish the benefits of barbed sutures and emphasizes the importance of surgeon experience and technique selection. Overall, this chapter provides valuable insights into vault closure in TLH, addressing various aspects and acknowledging areas requiring further research.