![]() The abdominal and vaginal approaches to hysterectomy remained the only surgical options until 1989, when Reich performed the first laparoscopic hysterectomy. The first successful hysterectomies were performed in the nineteenth century using vaginal or abdominal incisions. Hysterectomy is also performed for gynecologic cancers, including uterine, ovarian, fallopian tubal, cervical, and peritoneal cancers. The most common benign indications for hysterectomy include uterine leiomyomas, adenomyosis, abnormal uterine bleeding, endometriosis, and uterine prolapse. Hysterectomy is one of the most common surgeries performed on women in the United States, with approximately 600,000 performed each year. We hope to provide a better understanding of vaginal cuff closure for residents in the field of obstetrics and gynecology. ![]() Finally, a brief discussion of single-site surgery, the latest development in minimally invasive hysterectomy, will be provided. We also provide a review of the literature regarding vaginal cuff closure techniques and suture materials, including knotless barbed sutures. This review provides an overview of intracorporeal suturing and knot-tying techniques at the level of a junior resident in obstetrics and gynecology and describes several validated models that have been developed to test resident skill level in vaginal cuff closure. Vaginal cuff closure is a critical component of hysterectomy, with many variations in surgical technique and materials. The development of minimally invasive surgery has transformed this procedure, resulting in improved outcomes, superior cosmesis, and quicker return to normal function. ![]() Hysterectomy is one of the most common surgeries performed each year and can be indicated for many gynecologic conditions. ![]()
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