Laparoscopic Suturing of the Vaginal Cuff: A Surgical Education Module for Obstetrics and Gynecology Residents

Abstract

<h3>Study Objective</h3> We aim to review the assembly of a laparoscopic box trainer with a validated vaginal cuff model and to highlight principles for efficient two-handed laparoscopic vaginal cuff closure using three unique port configurations (ipsilateral, contralateral, and midline). This video was created as part of a surgical education module for Obstetrics and Gynecology residents. <h3>Design</h3> Surgical education video. <h3>Setting</h3> Laparoscopic box trainer with a validated vaginal cuff model. <h3>Patients or Participants</h3> Education module for Ob/Gyn resident physicians. <h3>Interventions</h3> The validated vaginal cuff model incorporates multiple layers to represent the vaginal epithelium and vaginal wall. We demonstrate laparoscopic suturing using a running technique from ipsilateral, contralateral, and suprapubic port configurations. A braided suture with a knot at the end simulates a unidirectional barbed suture that does not require knot tying. Critical steps needed for proper cuff closure are highlighted. <h3>Measurements and Main Results</h3> In this video, we highlight a reproducible setup of a validated vaginal cuff model within a laparoscopic box trainer. We demonstrate correct needle loading for enhanced accuracy in needle entry and exit. Efficient techniques to achieve adequate exposure, incorporation of vaginal epithelium, appropriate suture tension, and optimized ergonomics are also reviewed. <h3>Conclusion</h3> We present a surgical education video to teach safe and efficient laparoscopic suturing techniques to Ob/Gyn resident physicians using multiple two-handed port configurations. Key surgical principles include proper needle loading, needle entry, exposure, and optimized ergonomics.