Prospective randomized study to compare a closed vault technique using absorbable staples at the time of abdominal hysterectomy versus open vault technique.

The current prospective randomized study in 102 women having a hysterectomy compared closed vault technique using absorbable staples with open vault technique. Fifty-six patients had the cuff stapled while 46 patients had the vault sutured open. The groups were equivalent with respect to indications for operation as well as other surgical procedures performed in conjunction with the hysterectomy, although more patients were randomized to open vault. No patient left the study. Operating time in the group with staples was 24 minutes (standard deviation of seven minutes) compared with 33 minutes (standard deviation of eight minutes) with the group with the open vault (p<0.0001). Hemostasis was also better in the group with staples (p<0.0001). The frequency of postoperative granulation tissue at the apex of the vaginal vault and the incidence of vaginal discharge during 12 weeks of follow-up evaluation were also less in the group with staples.