Uterine manipulators are essential in laparoscopic procedures. They help a surgeon achieve a variety of tasks for a successful and safe surgical procedure. The basic use of a uterine manipulator is the mobilisation of a uterus.
When looking for a uterine manipulator to buy, there are various types you will come across. The ideal manipulator should be quick and convenient to use, inexpensive and safe. Here are the common types of uterine manipulators.
1. Endopath Uterine Manipulators
An Endopath uterine manipulator offers a perfect range of motion of about 130 degrees in an anteroposterior plane. It also allows lateral movement of the uterus by directing the handle from side to side. This uterine manipulator is, however, single-use and might thus be a bit expensive.
It is also hard for a surgeon to maintain the pneumoperitoneum and present vaginal fornices when using an Endopath uterine manipulator.
2. The HOHL Uterine Manipulator
This manipulator can allow movement of the uterus in the anteroposterior plane by up to 130 degrees. It enables independent uterine movement and is less traumatic compared to other types of uterine manipulators.
It is also reusable and hence cost-efficient. The HOHL uterine manipulator does not, however, lock in one position and does not delineate vaginal fornices as well as other manipulators.
3. Clermont-Ferrand Uterine Manipulator
This reusable instrument allows easy grasping of a patient’s lateral fornices and uterine pedicles and maintains the pneumoperitoneum. The uterus can be moved up to 140 degrees with a Clermont-Ferrand manipulator.
Use of this device, however, needs gross cervical dilatation and it might, therefore, be difficult to use in patients with cervical stenosis. It is also costly and needs extra training to handle correctly.
A VCare uterine manipulator allows sufficient exposure of a patient’s vaginal fornices and a broad range of uterine movements. It also allows a surgeon’s independent movements and maintains the pneumoperitoneum.
VCare manipulators are however disposable and might be unsuitable for a very bulky uterus since they are light.