Comparison of Uterine manipulators types in total Laparoscopic Hysterectomy: A retrospective study

OBJECTIVE: To compare the results of operations of commercial uterine manipulators. Considering that the optimal uterine manipulator is still not found, our goal was to give an idea for gynecologists to choose the most suitable uterine manipulator for their purposes and expectations. METHODS: Between January 2016 and September 2021, 294 laparoscopic hysterectomy cases met the inclusion criteria and were operated in İzmir Katip Çelebi University Atatürk Training and Research Hospital Gynecology and Obstetrics Clinic. They were divided into four groups according to the type of manipulator used. Group-1 (RUMI-I), Group-2 (Clermont-Ferrand), Group-3 (sharp intrauterine curette-tenaculum), and Group-4(without uterine manipulator). All four groups were compared with operation time, hospital stay, absolute change in hemoglobin (g/dl), and per-op complications. RESULTS: Considering the operation times in all groups, the mean operation time in the first Group-was 180 minutes (98-349); in Group-2 was 159 minutes (96-564); in the 3rd Group was 178 minutes (141-540); in the 4th Group was 189 minutes (115-453). The group with the shortest operation time was Group-2; the difference was statistically significant (p=0.015). In general terms, the effect of all manipulators on patient parameters wasn’t very different. Clermont-Ferrand seems more advantageous than others in making the surgeon’s work more straightforward regarding operation time only. CONCLUSIONS: In our study, the choice of uterine manipulator did not affect the surgical results except for the duration of the operation. The personalization of uterine manipulators according to the needs of the surgery and the easiness of use of the surgeon should be at the forefront.