Yavuzcan Ali, Altıntaş Raşit, Yıldız Gazi, Başbuğ Alper, Baştan Merve, Çağlar Mete
Department of Obstetrics and Gynecology, School of Medicine, Duzce University, Duzce, Turkey.
Urology Clinic, Burdur Bucak State Hospital, Burdur, Turkey.
Gynecol Minim Invasive Ther. 2021 Jan 30;10(1):19-24. doi: 10.4103/GMIT.GMIT_65_20. eCollection 2021 Jan-Mar.
Many surgeons use uterine manipulator (UM) during laparoscopic hysterectomy (LH). In this study, we aimed to compare the outcomes of LH operations performed by using partially reusable UM with the articulated system (artUM) and disposable (dUM) UM without articulation.
A total of 99 patients underwent the LH operation. This study was carried out with 35 of those 99 Caucasian patients who met the inclusion criteria. Group 1 consisted for 7 LH operations using the articulated RUMI II/KOH-Efficient™ (Cooper Surgical, Trumbull, CT, USA) system (artUM), while Group II consisted of 28 patients using old-type V Care(ConMed Endosurgery, Utica, New York, USA) dUM as UM.
Mean operation time was found to be 157.1 ± 42.0 min. The operation time was found statistically longer in Group 1, consisted of artUM used patients ( = 0.006 and < 0.05). No statistically significant difference was found between two groups in terms of surgical results such as, delta hemoglobin value ( = 0.483 and < 0.05), length of hospital stay ( = 0.138 and < 0.05), and postoperative maximum body temperature ( = 0.724 and < 0.05).
The UM type did not alter the surgical outcomes except the operating time in our study. According to our results, the surgical technique is a more significant variable than instruments used in LH for normal size uterus. Further prospective, large-scale studies comparing various UM systems are mandatory.
许多外科医生在腹腔镜子宫切除术（LH）中使用子宫操纵器（UM）。在本研究中，我们旨在比较使用带有关节系统的部分可重复使用UM（artUM）和无关节的一次性UM（dUM）进行LH手术的结果。
共有99例患者接受了LH手术。本研究对99例符合纳入标准的白种人患者中的35例进行。第一组包括7例使用带关节的RUMI II/KOH-Efficient™（美国康涅狄格州特朗布尔市库珀外科公司）系统（artUM）进行的LH手术，而第二组包括28例使用老式V Care（美国纽约州尤蒂卡市康美内镜外科公司）dUM作为UM的患者。
平均手术时间为157.1±42.0分钟。发现第一组（使用artUM的患者组）的手术时间在统计学上更长（P = 0.006，P<0.05）。两组在手术结果方面，如血红蛋白差值（P = 0.483，P<0.05）、住院时间（P = 0.138，P<0.05）和术后最高体温（P = 0.724，P<0.05），均未发现统计学上的显著差异。
在我们的研究中，除手术时间外，UM类型并未改变手术结果。根据我们的结果，对于正常大小子宫的LH手术，手术技术比所使用的器械是一个更重要的变量。进一步比较各种UM系统的前瞻性大规模研究是必要的。
