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Updated: Dec 7, 2025

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
The Development of a New Uterine Manipulation Method during Minimally Invasive Radical Hysterectomy
Seiji Mabuchi1, Emiko Niiro2, Mika Nagayasu2
1Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan (all authors)..
Study Objective:
The use of a vaginal uterine manipulator may compromise the oncological outcomes of patients with cervical cancer undergoing minimally invasive radical hysterectomy (MIS-RH). We aimed to describe the safety and efficacy of a novel uterine manipulation device during MIS-RH.
Design:
Retrospective study.
Setting:
A university hospital and a tertiary care hospital.
Patients:
Patients with early-stage cervical cancer who were treated with MIS-RH.
Interventions:
We developed the U-traction, a new device that consists of a 65-mm half-curved cutting needle with a 2.5-mm polyester tape (45-cm long), and investigated its utility to manipulate the uterus during MIS-RH.
Measurements And Main Results:
This study describes the utility and safety of the U-traction for uterine manipulation during laparoscopic or robotic RH in 8 patients with cervical cancer. Uterine manipulation was successfully and safely performed using the U-traction during laparoscopic or robotic RH in patients with cervical cancer without any complications. The application time was less than 5 minutes. In all cases, the use of a vaginal manipulator, an additional incision for an extra port, or the need for assistant surgeons for uterine manipulation was avoided.
Conclusion:
The novel U-traction device allows for easy and reproducible uterine manipulation during MIS-RH. With this device, the use of a vaginal uterine manipulator can be avoided, and MIS-RH can be safely performed without the need for an assistant surgeon for uterine manipulation.
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