VAGINAL VAULT EVISCERATION AFTER TOTAL LAPAROSCOPIC HYSTERECTOMY

Background: Vaginal vault rupture with intestinal herniation, although rare, is a recognized postoperative complication of vaginal and abdom inal hysterectomies. The incidence after laparoscopic hysterectomy is unknown. Cases: Three women, ages 40-43 years, presented to the emerge ncy room with bleeding and pain 2-5 months after total laparoscopic hy sterectomy. The small bowel was visible through the introitus or protr uding into the vagina. Inspection of the bowel revealed no evidence of trauma. Two vaginal cuff repairs were completed transvaginally and on e laparoscopically, all with interrupted sutures of no. 0 polydioxanon e or polyglactin. In follow-up period of 12-17 months, the patients we re doing well. Conclusion: Total laparoscopic hysterectomy may be asso ciated with an increased risk of vaginal vault evisceration. Because l aparoscopy increasingly is used to replace abdominal hysterectomy, it is important to be aware of this complication and its management.