Designing and prototyping a new uterine manipulator with two plane motion mechanism and LED marker illumination system

摘要

Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operation time, lower post-operative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. Firstly uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely during total laparoscopic hysterectomy (TLH). Uterine manipulators are used during TLH to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization and and amputation of the uterine cervix, which are difficult and hand skill required process. A new uterine manipulator has been designed and prototyped, which has 80 degrees sagittal and coronal plane motion capacity and Light Emitting Diode (LED) illumination system to ease the determinaion of correct line for cervical cauterization and amputation.