Modified uterine manipulator and vaginal rings for total laparoscopic radical hysterectomy

P. T. Ramirez, M. Frumovitz, R. Dos Reis, M. R. Milam, M. W. Bevers, C. F. Levenback, R. L. Coleman

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

At present, there is no standard technique that allows surgeons performing total laparoscopic radical hysterectomy to complete the colpotomy and remove an adequate (2-cm) margin of upper vaginal tissue while maintaining adequate pneumoperitoneum. We evaluated the feasibility and safety of using a modified uterine manipulator for total laparoscopic radical hysterectomy in patients with cervical or endometrial cancer. A retrospective review was performed in all patients who underwent total laparoscopic radical hysterectomy using a modified uterine manipulator at our institution during the period April 2004 to December 2006. This analysis included 30 patients who underwent surgery with the modified uterine manipulator. There were no reports of difficulty with placement of the instrument, multiple attempts at placement, difficulty with uterine manipulation, or uterine perforation. In no patient was a vaginal incision or episiotomy required to fit the instrument through the introitus. In no case was there loss of pneumoperitoneum during colpotomy. Additional upper vaginal tissue had to be removed after intraoperative assessment of the adequacy of the surgical specimen in five (16.7%) of 30 patients. Use of the modified uterine manipulator according to our technique is safe and feasible, allowing for adequate vaginal resection and maintenance of pneumoperitoneum.

Original languageEnglish (US)
Pages (from-to)571-575
Number of pages5
JournalInternational Journal of Gynecological Cancer
Volume18
Issue number3
DOIs
StatePublished - May 2008

Keywords

  • Cervical cancer
  • Laparoscopy
  • Radical hysterectomy
  • Uterine manipulator

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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