The Development of a New Uterine Manipulation Method during Minimally Invasive Radical Hysterectomy

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Vaginal uterine manipulators may negatively impact oncological outcomes in cervical cancer patients undergoing minimally invasive radical hysterectomy (MIS-RH).
• There is a need for safe and effective uterine manipulation techniques in MIS-RH.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel uterine manipulation device, U-traction, during MIS-RH for cervical cancer.
• To determine if U-traction can replace traditional vaginal manipulators and reduce the need for assistant surgeons.

Main Methods:

• Retrospective study involving 8 patients with early-stage cervical cancer undergoing MIS-RH.
• Development and application of the U-traction device, a 65-mm half-curved cutting needle with a 2.5-mm polyester tape.
• Laparoscopic or robotic radical hysterectomy procedures were performed using the U-traction device for uterine manipulation.

Main Results:

• Uterine manipulation with U-traction was successfully and safely performed in all 8 patients.
• No complications were reported during or after the procedure.
• The application time for U-traction was less than 5 minutes.
• The use of vaginal manipulators, extra incisions, or assistant surgeons for uterine manipulation was avoided.

Conclusions:

• The novel U-traction device facilitates easy and reproducible uterine manipulation during MIS-RH.
• U-traction offers a safe alternative to vaginal uterine manipulators, potentially improving oncological outcomes.
• This device enables safe MIS-RH without requiring an assistant surgeon for uterine manipulation.