Augmentation of Vaginal Cuff Closure During Laparoscopic Hysterectomy Using Viable Cryopreserved Umbilical Tissue

Abstract

Abstract

Background:

Hysterectomy is one of the most common female gynecologic surgeries. However, this surgery poses a risk for postoperative vaginal vault granulation, bleeding, infection, and dehiscence, which increases with patient comorbidities. These complications prolong recovery significantly and are the most common causes of postsurgical hospitalizations. Placental tissues have a long history of use for both wound treatments and surgical procedures. The benefits of placental tissues are attributed to their anti-inflammatory, antifibrotic, and antimicrobial properties. Advances in tissue preservation have led to the development and commercialization of this tissue for on-demand applications, including umbilical and amniotic grafts. This case report presents the first known use of viable cryopreserved umbilical tissue (vCUT) in a laparoscopic hysterectomy. The goals of this article are to assess safety and minimize risk for postoperative complications.

Case:

A 36-year-old female (gravida 0, para 0) with polycystic ovaries, insulin resistance, and recurrent, stage 4 endometriosis underwent an ovarian-sparing laparoscopic total hysterectomy. After removal of her uterus and cervix, vaginal cuff closure was augmented with vCUT.

Results:

Six weeks postoperatively, this patient had no granulation tissue, serosanguinous fluid formation, bleeding, odor, or pain. She did not report any other emergent events through 6 months post-op.

Conclusions:

This case report demonstrated the safety and proof-of-concept of vCUT use in patients who are at high risk for posthysterectomy surgical complications.