<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> The use of barbed suture in laparoscopic surgery is increasing ever since 2008. Published reports of use of unidirectional barbed suture for vaginal vault closure following total laparoscopic hysterectomy (TLH), indi</span><span style="font-family:Verdana;">cates it is safe. Despite of this many reports of adhesions and bowel obstruction </span><span style="font-family:Verdana;">are reported. This complication was never assessed in relation to amount of suture exposure at vaginal vault. We thought of quantifying the barbed suture exposure at vaginal vault and assess the risk of post-operative complications. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The objective was to quantify the exposure of barbed suture at vaginal </span><span style="font-family:Verdana;">vault by adopting a uniform technique of vault suturing and assessing p</span><span style="font-family:Verdana;">ost</span><span><span style="font-family:Verdana;">operative risk related to adhesions at vaginal vault. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">In 30 pati</span></span><span style="font-family:Verdana;">ents who underwent TLH, a uniform new technique of vaginal vault closure using barbed suture was used and the portion of suture exposed at vaginal vault was quantified. The patients were followed up for a period of 6 months to assess post-operative risk of adhesions at vault and sequalae. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> Mean length of suture exposed was 2.64 ± 1.65 mm only. Suture exposure at vaginal vault was seen in 23 (76.67%) out of 30 patients. The suture was exposed on average at 1.57 ± 1.20 places at vaginal vault. </span><b><span style="font-family:Verdana;">Conclusion and Recommendations:</span></b><span style="font-family:Verdana;"> The study with an