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A Novel Method to Facilitate Uterine Delivery at Robotic Hysterectomy
  1. Shih-Ern Yao, MBBS, FRANZCOG* and
  2. Tom Manolitsas, MBBS, FRCOG, FRANZCOG, CGO, MD
  1. * Monash Health Moorabbin, Bentleigh East; and
  2. Cabrini Health, Malvern, Victoria, Australia.
  1. Address correspondence and reprint requests to Tom Manolitsas, MBBS, FRCOG, FRANZCOG, CGO, MD, Cabrini Hospital—Malvern, Malvern, VIC 3144, Australia. E-mail: tom{at}


Abstract Minimally invasive platforms have afforded women undergoing hysterectomy the advantages of improved postoperative pain control, reduced complication rates, and shorter inpatient recovery time. In patients where malignancy has been confirmed or suspected, the necessity for uterine delivery per vagina is imperative to maintain these advantages without compromising oncological outcome.

A previously unreported technique of enlarging the apical circumference of the vagina during robotic hysterectomy facilitates intact uterine passage after extended reflection of the bladder and/or rectum. Significant increases in vault circumference can be gained through even small midline incisions of the vaginal wall, with an additional 5-cm incision almost doubling the apical aperture in certain cases.

We present our series of 21 cases that support this safe, reliable, and simple method for intact uterine delivery during robotic hysterectomy in minimally invasive gynecological oncology practice.

  • Robotic Surgery
  • Hysterectomy
  • Fibroids
  • Uterine Cancer
  • Morcellation

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  • The authors declare no conflicts of interest.