Uccella S, et al. - The present randomized study was performed to compare laparoscopic and transvaginal suture of the vaginal vault at the end of a total laparoscopic hysterectomy (TLH), in terms of incidence of vaginal dehiscence and vaginal cuff complications. Researchers also analyzed factors associated with vaginal dehiscence. Laparoscopic closure of the vaginal cuff at the end of TLH was found to be correlated with a significant reduction of vaginal dehiscence, any cuff complication, vaginal bleeding, vaginal cuff hematoma, postoperative infection, need for vaginal re-suture and reintervention. In multivariable analysis, transvaginal closure of the vault showed an independent association with a higher incidence of vaginal dehiscence and any vaginal complication; premenopausal status and smoking habit were observed to have an independent correlation with a higher risk of dehiscence.