ロボット支援下広汎子宮全摘術後に性交渉を機に腟断端離開をきたした一例

抄録

　Vaginal cuff dehiscence is a rare complication of total hysterectomy.　It occurs more frequently after laparoscopic or robotic hysterectomy than after abdominal or vaginal hysterectomy.

　A 39-year-old woman underwent robot-assisted radical hysterectomy for stage IB１ cervical cancer. The total operative time was ４ hours 51 minutes, the estimated blood loss was 100 mL, and there were no intraoperative complications. Three months later, the patient presented with sudden abdominal pain after intercourse. On examination, separation of the vaginal cuff and prolapse of the small intestine from the same site were observed, and emergency surgery was performed. The vaginal cuff was completely separated and repaired through laparoscopic surgery. The prolapsed small intestine was returned to the abdominal cavity with only mild erythema. The abdominal cavity was thoroughly cleaned, and vaginal end was sutured with a single nodule suture, and the same area was sutured transvaginally with a single nodule suture, resulting in a two-layer suture. The patient was discharged from the hospital after a good postoperative course.

　Post-hysterectomy vaginal cuff dehiscence is a rare but serious complication. As the use of robot-assisted hysterectomy becomes more widespread, it is necessary to accumulate cases and investigate methods to prevent and repair vaginal cuff dehiscence.