Vaginal Cuff Closure during Laparoscopic Hysterectomy Comparing the EndoStitch and RD-180 Suturing Devices

ABSTRACT

Introduction: To facilitate vaginal cuff closure, several endomechanical suturing devices can be used. This retrospective study was undertaken to compare two different devices to determine if there was an advantage to either device. Methods: Laparoscopic hysterectomies performed where vaginal cuff closure times could be measured on recorded video were reviewed. Demographic information was obtained on these cases and the two suturing devices were compared. Results: Cuff closure times with the EndoStitch® (Covidien, Norwalk, CT) and the RD-180® (LSI Solutions, Rochester, NY) devices were evaluated for overall cuff closure time, per stitch time, and assessed for confounding factors. The EndoStitch had an overall faster cuff closure time than the RD-180 (17.2 minutes vs. 20.1 minutes, p = 0.046). However, the per-stitch closure times were similar (5.66 minutes/stitch, 5.56 minutes/stitch, p = 0.78). No conversions to laparotomy and no cuff dehiscences were experienced. Per-stitch closure time was not affected by the level of resident, but was lengthened by increased patient body mass index. However, closure times were longer with both devices than when using barbed suture and conventional suturing techniques. Conclusions: Both the EndoStitch and RD-180 suturing devices provide a reasonable cuff closure time with a low risk of cuff dehiscence. The learning curve for both instruments is relatively flat. (J GYNECOL SURG 37227) © Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.