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Extracorporeal ligation applying a knot pusher (Fig. 3A) and intracorporeal ligation Extracorporeal ligation employing a knot pusher (Fig. 3A) and intracorporeal ligation working with a straight needle holder or right-angled grasper. Vaginal manual ligation was carried out in Endo Stitch suture and continuous vault closure immediately after PCSS (Fig. 2A) (situations 22-119). three. Statistical analysis Statistical evaluation was performed using SAS Enterprise guide ver. 4.1 (SAS institute Inc., Cary, NC, USA). Shapiro-Wilk test was performed to assess typical distribution of variables. Evaluation of variance (ANOVA) or Kruskal-Wallis test was per-www.ogscience.orgDaehyun Park, et al. Laparoscopic vaginal vault closure in SPA-TLHABCDAbdominal wallPeritoneusm Vaginal cuffEFFig. three. (A) Extracorporeal tie with knot-pusher (arrow: vaginal help). (B) Vaginal vault prolapsed after SPA-TLH (salpinx). (C) Prolapsed salpinx removed right after ligation. (D) Vault suture in 4-port TLH (continuous suture, schematic view). (E) Insertion of Monocryl 1-0 for vault closure (arrow: needle). (F) Continuous suture on cut-end of vesicocervical (left arrow), uterosacral (correct arrow) ligament. SPA-TLH, single-port access total laparoscopic hysterectomy.formed for the comparison of continuous variables as outlined by normality. For post-hoc test, Tukey test was utilised for ANOVA and bon or sidak or Holm was utilised for Kruskal-Wallis. Moreover, chi-square test or Fisher's precise test have been made use of for the comparison of nominal variables. P -values of less than 0.05 had been viewed as statistically considerable. Endo Stitch suture groups (suture along in 2 situations, suture following PCSS in 2 situations) could not satisfy normality in continuous vault closure devoid of PCSS and vaginal suture groups. This study employed Kruskal-Wallis test for the evaluation of data as a parametric test. For the parametric test, Wilcoxon rank sum test was performed a number of instances for post-hoc test, along with the difference was modified applying Bonferroni, Sidak, or Holm approach. Median was 44.five minutes (range, 19-56 minutes) in PCSS group. Median was 22 minutes (range, 16-31 minutes) in a group performed with continuous vault closure with out PCSS.Operation time of no PCSS group was practically similar as vaginal suture (20 minutes) (Table 1) in vault closure suture. Nevertheless, statistically significant difference was not identified in all modified P -values (P >0.05) (Table two).ResultsSPA-TLH was performed to 152 patients throughout this investigation and single-port laparoscopy was completed in 119 situations (78 ). Nevertheless, 24 instances (16 ) had been converted to multiport laparoscopy (2D), and 9 instances (six ) were converted to laparotomy. Among 119 cases, 8 circumstances (7 ) underwent vaginal suture (median, 20 minutes; variety, 15-44 minutes), 111 situations (93 ) underwent laparoscopic suture. In laparoscopic suture group, 4 circumstances (three ) received extracorporeal ligation (Fig. 3A) applying awww.ogscience.orgTime Case PCSS Time Other Case PCSS Time Other Case PCSS Time Other Case PCSS Time Other (min) (min) (min) (min) (min) 17 26 15 17 19 44 21 25 36 53 50 45 13 30 33 50 54 55 49 48 52 43 44 45 46 1.