A 39-year-old patient with complex endometrial hyperplasia without atypia underwent robotic total laparoscopic hysterectomy with bilateral salpingo-oophorectomy. The procedure was technically challenging because of the patient's obesity (body mass index 50 kg/m(2)). Concomitant suction of pooled blood and retraction of bowel and omentum were necessary to close the vaginal cuff. An endoscopic retractor was used through the assistant's port, and a Yankauer suction tip was placed through an inflated Colpo-Pneumo Occluder balloon in the vagina to provide directed suction to the vagina cuff. This technique enabled efficient closure of the vaginal cuff.
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