The Development of a New Uterine Manipulation Method during Minimally Invasive Radical Hysterectomy

Mabuchi, Seiji; Niiro, Emiko; Nagayasu, Mika

doi:10.1016/j.jmig.2020.09.015

Cited by 5 publications

(9 citation statements)

References 14 publications

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“…The 5-year survival rate of cervical cancer patients became higher as the negative lymph node (NLN) count increased, and the overall survival rate of patients with NLN counts >25 was significantly higher than that of those with NLN counts ≤25 (p < 0.001). 21 Our study achieved a median of 27 (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) NLN resections. These data suggested that we optimized the surgical techniques without weakening the surgical radicality.…”

Section: Discussionmentioning

confidence: 83%

“…All patients had IA2-IB2 stage disease (FIGO 2018). The median number of pelvic lymph nodes removed was 27 (range [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Sufficient amounts of paracervical tissue (median 24 mm) and vaginal tissue (median 18 mm) were cut off.…”

Section: Resultsmentioning

confidence: 99%

“…29 Boztosun et al 30 and Kanao et al 31 also performed similar modified uterine suspension methods. In rapid sequence, a combination suture of the round ligament, ovary ligament, and fallopian tube conducted by Yuan et al 32 and U-traction conducted by Mabuchi et al 33 were successively reported in LRH. All of these techniques were well replaced by the use of uterine manipulators in hysterectomy only, however, relatively few similar studies have been published in LRT.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Huo

Huang

et al. 2022

J of Obstet and Gynaecol

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Aim:The purpose of this study was to investigate the surgical techniques and clinical feasibility of nonuterine manipulator and enclosed colpotomy to avoid cancer cell spillages in laparoscopic radical trachelectomy (LRT) for patients with early-stage cervical cancer. Methods: We performed the newly optimized surgical techniques of round ligament suspension and vaginal purse-string suture in LRT in 12 patients with early-stage cervical cancer from May 2019 to October 2020. Surgical information and postoperative results were recorded. Results: All 12 patients successfully underwent LRT with round ligament suspension and vaginal pursestring suture, and no conversion to laparotomy was required. The median operation time was 268.5 min (range 200-320 min), including 5 min of round ligament suspension, and the median blood loss was 20 mL (range 5-50 mL). The median number of pelvic lymph nodes removed was 27 (range 19-35), and median amounts of paracervical tissue was 24 mm (range 21-26 mm) and vaginal tissue was 18 mm (range 16-26 mm). No intraoperative complication or serious postoperative complications were reported. Conclusion: Round ligament suspension and vaginal purse-string suture techniques are feasible and effective in LRT. They can replace uterine manipulator and unprotected colpotomy with satisfactory perioperative outcomes.

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Section: Discussionmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Huo

Huang

et al. 2022

J of Obstet and Gynaecol

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“…Despite whether manipulation of the uterus without a uterine manipulator improves outcomes is inconclusive, there are still other novel explorations to avoid using a uterine manipulator in addition to utilizing the 3 rd RA to pull the uterine horn this study adopted. Mabuchi et al (34) invented a new uterine manipulation device, a Utraction consisting of a 65-mm half-curved cutting needle with a 2.5mm polyester tape, to ease uterine manipulation of LRH in 8 IB1 cervical cancer patients. Results indicated that no intraoperative complications occurred.…”

Section: Discussionmentioning

confidence: 99%

An optimized robotic surgical technique for cervical cancer: investigating whether the use of the pulling robotic arm has better surgical outcomes

Liang

et al. 2023

Front. Oncol.

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ObjectiveThe evidence for adopting the 3rd robotic arm (RA) called the pulling RA rather than a uterine manipulator to manipulate the uterus in the robotic radical hysterectomy (RRH) for cervical cancer is still limited. We present a single-center retrospective experience comparing using the pulling RA to replace a uterine manipulator vs. using a uterine manipulator to manipulate the uterus in RRH.Methods106 patients diagnosed with IA, IB1-IB2 and IIA1 cervical cancer were retrospectively included for intraoperative and postoperative parameters analysis. 50 patients received RRH by adopting the pulling RA instead of a uterine manipulator to pull the uterus (3-RA RRH group), and another 56 patients were performed RRH with a uterine manipulator (2-RA RRH group). RRH with the pulling RA consisted of a camera arm, 3 RAs including a pulling RA, and 2 conventional assistant arms (3-RA RRH group). In comparison, RRH with a uterine manipulator included 2 RAs and 2 conventional assistant arms (2-RA RRH group). Besides, 3-RA’ RRH group was selected from the 25th-50th cases in the 3-RA RRH group based on the learning curve and was compared with the 2-RA RRH group in terms of intraoperative and postoperative parameters.ResultsThe patients’ early post-operative complication (≤7 days) (p=0.022) and post-operative anemia (p < 0.001) of the 3-RA RRH were significantly lower than that in the 2-RA RRH group. The results of comparing the 2-RA RRH group with the 3-RA’ RRH group were consistent with the aforementioned results, except for the operative time (220.4 vs. 197.4 minutes, p=0.022) and hospital stay (7.8 vs. 8.7 days, p=0.034). The median follow-up in the 3-RA RRH and 2-RA RRH groups was 29 and 50 months till March 2023. The 3-RA RRH and 2-RA RRH groups’ recurrence rates were 2% (1/50) and 5.4% (3/56), respectively. The mortality in the 3-RA RRH and 2-RA RRH groups was 2% (1/50) and 3.5% (2/56), respectively.ConclusionOur study suggested that replacing the uterine manipulator via the 3rd RA is viable; the results showed comparable surgical outcomes between the two methods. Thus, 3-RA RRH could be considered a well-executed surgical option in well-selected patients.

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“…“Vaginal cuff closure” was designed to replace uterine manipulator during MIS in some studies [ 21 22 23 ]. Recently, Mabuchi et al [ 24 ] developed a novel manipulation device, the U-traction, which could be used during MIS with safety and utility. Successful results were reported, but there were limitations, such as the potential risk of spillage of tumor cells, inadvertent bleeding caused by tissue tearing on sutures [ 24 ], lack of control, unclear exposure, and difficult operation.…”

Section: Introductionmentioning

confidence: 99%

The sealing effect of magnetic-sealing uterine manipulator in isolated uterus from patients with early-stage cervical cancer: a pre-clinical study

Zhou

Liang

et al. 2023

J Gynecol Oncol

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Objective Traditional uterine manipulator is considered as the main reason for short survival of patients with early-stage cervical cancer during minimally invasive surgery. This study aims to assess the sealing effect of magnetic-sealing uterine manipulators (MUMs) in isolated uteruses. Methods The study was performed on isolated uterus from patients with early-stage cervical cancer who underwent open abdominal radical hysterectomy between November 2019 to April 2021. Right-angle forceps closure tests (groups 1 and 3) were defined as control tests. One experimental MUM closure test (group 2) and 2 control tests were respectively carried out in each of the isolated uterus. DNA ploidy analysis system was used to observe exfoliated cells. Statistical analysis was performed using Wilcoxon signed-rank test to assess the sealing effect of MUM. Results We identified 36 patients. No regional node metastasis was discovered and only one tumor was larger than 4.0 cm in diameter. The mean of exfoliated tumor cells in groups 1, 2, and 3 were 1, 1, and 2, respectively. There was no significant difference in the quantity of exfoliated cells between groups 1 and 3 (p=0.476), so the results of the 2 groups were merged. Subsequently, a significant difference was observed between combined right-angle forceps closure tests and MUM closure tests (p=0.022). Conclusion The sealing effect of MUM was better than that of right-angle forceps. MUM can effectively seal cervical cancer cells in the cup cover, avoiding the dissemination of tumor cells. Trial Registration Chinese Clinical Trial Register Identifier: ChiCTR1900026012

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The Development of a New Uterine Manipulation Method during Minimally Invasive Radical Hysterectomy

Cited by 5 publications

References 14 publications

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

An optimized robotic surgical technique for cervical cancer: investigating whether the use of the pulling robotic arm has better surgical outcomes

The sealing effect of magnetic-sealing uterine manipulator in isolated uterus from patients with early-stage cervical cancer: a pre-clinical study

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