Statement of the problem: 
Safety profile between Vaginal Cuff Closure  (VCC) and Laparoscopic Cuff Closure  (LCC) in Total Laparoscopic Hysterectomy  (TLH).
Methodology:
A total of 62 patients undergoing TLH in Nagaland Multi-speciality Hospital, Dimapur, Nagaland, India, over 12 months were divided into two(2) groups .The first group  (30) patients underwent VCC using Vicryl 1-0 and in the second group  (32) patients, LCC was performed using the same suture material  (Vicryl 1-0).
All TLH were performed  by the same surgeon only.  The cuff related complications like , Pain, Vault spotting/bleeding, Vaginal disruption/dehiscence, Watery discharge,  Granulation tissue,Cuff infections  was taken into the account of the study,  by performing a Per- speculum examination over the 2 weeks post-operative period.
Findings: 
Out of 30 patients in the first group, 12 (40%) had significant pain requiring strong analgesics, 5 (16%) had watery discharge, 3 (10%) had spotting per vaginum. On speculum examination,  the vault margins were everted with irregular granulation tissue with watery discharge and exposed to vaginal flora. 
In the second group  (LCC),less pain with insignificant cuff related complications was seen.The vault margins were inverted and thereby not exposed to the vaginal flora. No cuff prolapse/ dehiscence was seen in either of the two groups. 

Conclusions & Significance: 
The only advantage of VCC over LCC was the median time taken for closure which was about 12 minutes quicker than LCC. Apart from this,Cuff related complications like pain in VCC was attributed to the excessive pulling of the utero-sacral ligaments  and vaginal tissues. In the LCC group, the utero-sacral ligaments was properly visualized and therefore well incorporated in the suture for effective vault suspension. 
The significance of the LCC over VCC is therefore the safest route of Vaginal Cuff Closure in TLH.