الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hysterectomy is the most common gynaecological surgery around the world, especially for benign conditions such as menorrhagia, fibroids, pelvic pain and uterine prolapse.[1,2] The surgical approach includes abdominal, vaginal or laparoscopic routes. The first laparoscopic hysterectomy (LH) was performed in1989 by Reich et al. [3] In subsequent years, the first series of laparoscopy-assisted vaginal hysterectomies (LAVH) and laparoscopic subtotal hysterectomies (LASH) were described by Mage et al. [4] Donnez and Nisolle [5] and Lyons.[6] Laparoscopy has many advantages compared to laparotomy, including less pain, fewer infections,shorter hospital stay and faster recovery time.[7] The magnification provided by laparoscopic instruments enables easy access to the uterine vessels, ureter, rectum and vagina.[8] During the past 30 years, laparoscopy has advanced rapidly, following improvements in video camera and electrical surgery technology. Conventional laparoscopy, with three or four small incisions, has become the gold standard for many gynaecological diseases, from benign conditions to endometrial cancer.[9,10] Recently, total laparoscopic hysterectomy (TLH) has received wider acceptance world wide, as the surgeons have gained experience. In minimally invasive hysterectomy, the vaginal cuff is sutured closed by a variety of possible techniques. Institutional and individual variation exists between the following elements of cuff closure: intracorporeal versus transvaginal closure, suture material, and suture technique. The aim of this study : was to compare between closure of vaginal cuff after total laparoscopic hysterectomy translaparoscopic intracorporial closure or through vaginal closure. The current study was carried out on 80 women undergoing total laparoscopic hysterectomy for benign lesions in Gynecology department at Tanta University Hospital and BhaktiVedanta Hospital in Mumbai India, the study started on March 2020 till Feb 2023. Patients were classified into 2groups: group I Intracorporial closure(40 patients) was subjected to do total laparoscopic hysterectomy with vaginal cuff closure through intracorporial laparoscopic suture using vicryl 1. group II Vaginal closure (40 Patients) was subjected to do total laparoscopic hysterectomy with vaginal cuff closure through vaginal route using vicryl 1. As regard age ,there was no significant difference between two groups. As regard BMI ,there was no significant difference between two groups. As regard parity ,there was highly significant difference between the two groups. As regard history of previous surgeries , there was no significant difference between two groups. As regard medical co morbidities among the study groups there was no significant difference between two groups. As regard indications for TLH , there was no significant difference between two groups. 96 Summary As regard incidence of intraoperative complications it was high in vaginal group ,but, there was no significant difference between two groups. We found that Post-operative Vaginal length in Laparscopic group was higher than vaginal group, While other postoperative complications were less in laparoscopic than vaginal route but the difference wasn’t statistically significant .