Disposable Uterus Manipulator

Components and Design

1. Handle: The portion of the device that the surgeon or assistant holds and operates. It often includes controls for adjusting the position and angle of the uterus.
2. Manipulator Shaft: A long, slender rod that extends into the vaginal canal and into the uterus. It is designed to be inserted through the cervix.
3. Uterine Tip or Cup: The part of the manipulator that contacts and supports the uterus. Different tips or cups are available for various types of surgeries and anatomical variations.
4. Articulating Joint: Some manipulators have an articulating joint that allows for multidirectional movement of the uterus, enhancing the surgeon’s ability to achieve the desired positioning.
5. Inflation Mechanism: Some models include a balloon that can be inflated inside the uterus to secure the device in place and provide gentle pressure for manipulation.

Uses

• Laparoscopic Hysterectomy: Removal of the uterus.
• Laparoscopic Myomectomy: Removal of fibroids from the uterus.
• Endometriosis Treatment: Resection of endometrial tissue.
• Pelvic Organ Prolapse Repair: Procedures to correct prolapse of pelvic organs.
• Tubal Sterilization: Procedures to block or remove the fallopian tubes.
• Fertility Procedures: Assisting in various fertility treatments.

Benefits

1. Enhanced Visualization: By repositioning the uterus, manipulators help expose the pelvic organs, improving the surgeon’s view and access during minimally invasive procedures.
2. Stabilization: Keeps the uterus in a fixed position, reducing the risk of injury to adjacent organs and tissues.
3. Improved Surgical Outcomes: Facilitates precise dissection and suturing, leading to more efficient and safer surgeries.
4. Reduced Operative Time: Streamlines the procedure by allowing for quick and easy repositioning of the uterus.

Procedure

1. Preparation: The patient is placed in a lithotomy position (lying on their back with legs elevated).
2. Insertion: The manipulator is carefully inserted into the vaginal canal and through the cervix into the uterine cavity.
3. Positioning: The surgeon or assistant adjusts the handle to position the uterus as needed for the specific surgical procedure.
4. Operation: Throughout the surgery, the manipulator is used to move and stabilize the uterus, providing optimal exposure and access to the pelvic organs.
5. Removal: Once the procedure is complete, the manipulator is gently removed.

Types and Variations

1. Disposable vs. Reusable: Disposable manipulators are designed for single use to ensure sterility and prevent cross-contamination. Reusable manipulators can be sterilized and used for multiple procedures.
2. Simple vs. Articulating: Simple manipulators offer basic positioning capabilities, while articulating manipulators provide more complex movements and adjustments.
3. Inflatable Tips: Some models feature inflatable balloons that secure the manipulator within the uterus.

Examples of Uterus Manipulators

1. RUMI (Re-Usable Manipulator Injector): Features an articulating tip and an inflation mechanism for secure placement.
2. Koh Colpotomizer System: Includes a ring to facilitate colpotomy (incision into the vaginal wall) during hysterectomy.
3. Vcare Uterine Manipulator: Combines manipulation and suction capabilities for enhanced control.

Uterus manipulators are essential tools in modern gynecological surgery, enabling surgeons to perform complex procedures with greater precision, safety, and efficiency.