Comparison of simple uterine manipulator-injector (SUMI) with the Cohen cannula in gynecologic laparoscopy

Abd-El-Maeboud, Karim H. I.; Elbohoty, Ahmed; Amer, Moatassem S.; Tharwat, Alaa; Khalifa, Amer Abd-Al-Aziz

doi:10.1016/j.mefs.2011.07.006

Cited by 1 publication

(1 citation statement)

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“…Lateral movement allows exposure of the pelvic ligaments, and utero-ovarian and anterior-posterior leaves of the broad ligament. Antero-posterior movement exposes the anterior uterine wall if associated with elevation movement of the vesico-uterine fold, and posterior uterine wall [ 48 ]. For example, during rectovaginal endometriosis surgery, the manipulator is particularly important because the upward motion of the uterus into the pelvis enhances the view of the uterosacral ligaments and cul-de-sac [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

et al. 2022

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An acquired uterine artery myometrial pseudoaneurysm can occur due to inflammation, trauma, or iatrogenic causes, such as surgical procedures, and can lead to profuse bleeding. The efficacy of uterine manipulators in gynecological surgery, particularly as a cause of a pseudoaneurysm, has been poorly discussed in the literature. In this paper, we discuss a case of a 39-year-old woman with profuse uterine bleeding that occurred seven days after operative laparoscopic surgery for endometriosis. The color Doppler ultrasound better evoked the arterial-like turbulent blood flow inside this cavity. These sonographic features were highly suggestive of uterine artery pseudoaneurysm, presumably related to a secondary trauma caused by the manipulator. The diagnosis was subsequently re-confirmed by angiography, and the patient was treated conservatively with uterine artery embolization. Ultrasound has been shown to be a valuable and safe tool for imaging pseudoaneurysm and guiding subsequent interventional procedures. Accordingly, we briefly review the most suitable manipulators used in benign gynecological surgeries to verify if the different types in use can guide the surgeon towards the correct choice according to surgical needs and thus prevent potentially dangerous trauma.

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Section: Discussionmentioning

confidence: 99%