Total laparoscopic hysterectomy without uterine manipulator. A retrospective study of 1023 cases

Zygouris, Dimitrios; Chalvatzas, Nektarios; Gkoutzioulis, Antonios; Anastasiou, Georgios; Kavallaris, Andreas

doi:10.1016/j.ejogrb.2020.08.035

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…In another study, the authors described a method of TLH without UM use [24]. They employed grasping forceps for uterine manipulation and concluded that this technique was a feasible and safe approach.…”

Section: Resultsmentioning

confidence: 99%

Surgical Outcomes of Intraabdominal versus Vaginal Approach for Uterine Manipulation during Total Laparoscopic Hysterectomy

GÜVEN¹,

Uysal

Kolsuz

et al. 2022

Preprint

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Background: Uterine manipulation is essential for moving the uterus and proper anatomical dissection without complications during total laparoscopic hysterectomy (TLH). Although many different uterine manipulators (UM) have been designed in the last few decades, there is still no ‘optimal UM’ that is universally safe, efficient, and cost-effective. This study aimed to compare myoma screw (MS) and UM with regard to surgical outcomes and cost-effectiveness in patients who underwent TLH. Methods: In the current study, we describe an operation technique that uses a MS instead of a uterine manipulator during TLH and discuss the surgical outcomes of this method. Results: The use of MS resulted in significantly shorter operation time with respect to UM for uterine manipulation during TLH regarding benign indications, with affordable costs. Conclusion: The use of MS is a safe and cost-effective alternative to the use of UM during TLH.

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Section: Resultsmentioning

confidence: 99%

Surgical Outcomes of Intraabdominal versus Vaginal Approach for Uterine Manipulation during Total Laparoscopic Hysterectomy

GÜVEN¹,

Uysal

Kolsuz

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In another study, the authors described a method of TLH without UM use. [24] They employed grasping forceps for uterine manipulation and concluded that this technique was a feasible and safe approach. They emphasized that their technique offers particular benefits in some circumstances; for instance, in patients with vaginal stenosis or patients with a distorted cervix, in the absence of UM, and in early-stage cervical or endometrial cancer surgeries.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of intraabdominal versus vaginal approach for uterine manipulation during total laparoscopic hysterectomy

Güven¹,

Uysal²,

Kolsuz³

et al. 2023

Medicine

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Uterine manipulation is essential for moving the uterus and proper anatomical dissection without complications during total laparoscopic hysterectomy (TLH). Although many different uterine manipulators (UM) have been designed in the last few decades, there is still no “optimal UM” that is universally safe, efficient, and cost-effective. This study aimed to compare myoma screw (MS) and UM with regard to surgical outcomes and cost-effectiveness in patients who underwent TLH. In the current study, we describe an operation technique that uses a MS instead of a uterine manipulator during TLH and discuss the surgical outcomes of this method. The use of MS resulted in significantly shorter operation time with respect to UM for uterine manipulation during TLH regarding benign indications, with affordable costs. The use of MS is a safe and cost-effective alternative to the use of UM during TLH.

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“…Zygouris et al [ 55 ] presented only one case of ureteral injury and three cases of bladder opening during laparoscopy in a retrospective study with 1023 patients who underwent laparoscopic hysterectomy without the use of a manipulator. The authors concluded that a TLH without using a manipulator is achievable and safe when performed by an experienced laparoscopic surgeon, with short surgical time and a low rate of complications.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

et al. 2022

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An acquired uterine artery myometrial pseudoaneurysm can occur due to inflammation, trauma, or iatrogenic causes, such as surgical procedures, and can lead to profuse bleeding. The efficacy of uterine manipulators in gynecological surgery, particularly as a cause of a pseudoaneurysm, has been poorly discussed in the literature. In this paper, we discuss a case of a 39-year-old woman with profuse uterine bleeding that occurred seven days after operative laparoscopic surgery for endometriosis. The color Doppler ultrasound better evoked the arterial-like turbulent blood flow inside this cavity. These sonographic features were highly suggestive of uterine artery pseudoaneurysm, presumably related to a secondary trauma caused by the manipulator. The diagnosis was subsequently re-confirmed by angiography, and the patient was treated conservatively with uterine artery embolization. Ultrasound has been shown to be a valuable and safe tool for imaging pseudoaneurysm and guiding subsequent interventional procedures. Accordingly, we briefly review the most suitable manipulators used in benign gynecological surgeries to verify if the different types in use can guide the surgeon towards the correct choice according to surgical needs and thus prevent potentially dangerous trauma.

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Total laparoscopic hysterectomy without uterine manipulator. A retrospective study of 1023 cases

Cited by 11 publications

References 25 publications

Surgical Outcomes of Intraabdominal versus Vaginal Approach for Uterine Manipulation during Total Laparoscopic Hysterectomy

Surgical Outcomes of Intraabdominal versus Vaginal Approach for Uterine Manipulation during Total Laparoscopic Hysterectomy

Surgical outcomes of intraabdominal versus vaginal approach for uterine manipulation during total laparoscopic hysterectomy

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

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