8802 GYN 101: Introduction to Uterine Manipulators

Abstract

<h3>Study Objective</h3> To understand the insertion techniques and use of various types of uterine manipulators. <h3>Design</h3> This video highlights the importance behind the use of manipulators during laparoscopy and identifies unique aspects of various types of manipulators. Additionally, we review how to properly insert and use manipulators. <h3>Setting</h3> The patient is placed in dorsal lithotomy for the video. <h3>Patients or Participants</h3> One patient is filmed to demonstrate the placement of a Fornisee manipulator for a robotic assisted total laparoscopic hysterectomy. A combination of simulation models and photographs were also utilized to review educational topics. <h3>Interventions</h3> The utility of manipulators during laparoscopy, various types of manipulators, and proper insertion techniques are reviewed. <h3>Measurements and Main Results</h3> We review how uterine manipulators assist with visualization, elevate the uterine vessels farther away from the ureters and bladder, and delineate the cervicovaginal junction assisting with colpotomy. Many manipulators have unique aspects that make them favored for specific clinical situations. This video demonstrates how extracorporeal hand movements position the uterus in an opposite fashion intra-abdominally. <h3>Conclusion</h3> It is important to know different manipulator types to tailor their use to specific clinical scenarios. Safe and accurate placement and proper movements are crucial in assisting the surgeon, especially during important dissection steps.