The Hohl instrument for optimizing total laparoscopic hysterectomy: results of more than 500 procedures in a university training center

Mueller, Andreas; Boosz, Alexander; Koch, Martin; Jud, Sebastian M.; Faschingbauer, Florian; Schrauder, Michael G.; Löhberg, Christian; Mehlhorn, Grit; Renner, Stefan P.; Lux, Michael P.; Beckmann, Matthias W.; Thiel, Falk

doi:10.1007/s00404-011-1905-y

Cited by 31 publications

(14 citation statements)

References 43 publications

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“…Most publications were found regarding this manipulator: three prospective studies, one retrospective study, a product survey and one case report [4,7,[12][13][14][15][16]. One retrospective study and one prospective cohort study were performed by Mueller et al [4,14], including 44 and 567 patients, respectively. One ureter injury, four bladder injuries and one vagina injury occurred.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of uterine manipulators in laparoscopic surgery: a review

Haak

Alleblas

Nieboer

et al. 2015

Arch Gynecol Obstet

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Purpose This review aims to objectively assess the efficacy and safety of uterine manipulators as reported in scientific literature. Furthermore, it evaluates as to which manipulator best suits which surgical procedure. Methods PubMed, Embase, Web of Science, COCHRANE, CINAHL, Academic Search Premier, Science Direct and the MAUDE database were searched. Technical information was retrieved from the manufacturers. Results 25 articles covering 10 uterine manipulators were found. Studies regarding implementation and use of manipulators are scarce; only two surveys were found comparing different manipulators. Moreover, clinical evidence proving the efficacy of manipulators with respect to prevention of complications, inherent to laparoscopic surgery, does not exist. Conclusion The use of uterine manipulators is well established and it is clear that uterine manipulators offer the easiest way to handle the uterus during surgery. However, detailed information regarding efficacy and safety is scarce. Clinical evidence substantiating the assumed mechanism of prevention of ureter injuries was not found. Our review did not find the optimal manipulator. Some are more versatile than others and not all instruments are appropriate for all types of surgery. Therefore, gynecologists should choose the manipulator that best suits the type of surgery that is performed.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of uterine manipulators in laparoscopic surgery: a review

Haak

Alleblas

Nieboer

et al. 2015

Arch Gynecol Obstet

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“…In a multi-centre, randomised study involving 21 Dutch hospitals, laparoscopic hysterectomy (TLH) was compared with open abdominal hysterectomy (TAH) in relation to complication rates and the associated costs in 283 patients with endometrial adenocarcinoma of the uterus (stage I) or complex atypical hyperplasia [53]. The TLH had a lower complication rate (2.7 %) than the TAH (4.3 %), which other studies also confirm [54]. The costs of a TLH were € 3453 and the costs of a TAH € 3577.…”

Section: Surgical Treatmentmentioning

confidence: 74%

“…In this case "high-tech" and "high-cost" are both to the benefit of the patient [56]. From an ethical perspective, laparoscopy is associated with the least physical trauma, the lowest level of analgesia consumption and the shorter inpatient stay and can therefore not be rejected [54,57,58]. The results of the health services research underscore the need for more adequate and more appropriate remuneration and a fair representation of minimally-invasive procedures.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Health Services Research and Health Economy – Quality Care Training in Gynaecology, with Focus On Gynaecological Oncology

Lux

Fasching

Loehberg

et al. 2011

Geburtsh Frauenheilk

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In the era of cost increases and reduced resources in the German healthcare system, the value of health services research and health economics is increasing more and more. Health services research attempts to develop concepts for the most effective ways to organise, manage, finance and deliver high-quality care and evaluates the implementation of these concepts with regard to daily routine conditions. Goals are the assessment of benefits and the economic advantages and disadvantages of new and established diagnostic methods, drugs and vaccines. Regarding these goals, it is clear that health services research goes hand in hand with health economics, which evaluates the benefits of diagnostic and therapeutic procedures in relation to the costs. Both scientific fields have focus principally on gynaecology and particularly on gynaecological oncology in Germany, as can be seen by numerous publications. These present several advantages compared with clinical trials ? they uncover gaps in health care, question the material, staffing and consequently the financial resources required and they allow the estimation of value and the comparison of different innovations to identify the best options for our patients.

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“…Subtotal or total laparoscopic hysterectomy is a standard procedure in our university hospital, and the surgeons are experienced with the technique, as reported elsewhere [14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Comparison of reoperation rates, perioperative outcomes in women with endometrial cancer when the standard of care shifts from open surgery to laparoscopy

Boosz

Haeberle

Renner

et al. 2014

Arch Gynecol Obstet

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The Hohl instrument for optimizing total laparoscopic hysterectomy: results of more than 500 procedures in a university training center

Abstract: Total laparoscopic hysterectomy using the Hohl instrument simplifies the surgical procedure. The technique reported here is safe and effective in preventing ureteral complications during TLH, even in a university training program.

Cited by 31 publications

References 43 publications

Efficacy and safety of uterine manipulators in laparoscopic surgery: a review

Efficacy and safety of uterine manipulators in laparoscopic surgery: a review

Health Services Research and Health Economy – Quality Care Training in Gynaecology, with Focus On Gynaecological Oncology

Comparison of reoperation rates, perioperative outcomes in women with endometrial cancer when the standard of care shifts from open surgery to laparoscopy

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