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2022-VA-1229-ESGO Novel method of uterine traction in robot assisted total hysterectomy
  1. Kazunari Fujino
  1. Obstetrics and Gynecology, Juntendo University, Tokyo, Japan


Introduction/Background One of the important procedures for safely performing robot assisted total hysterectomy is uterine traction, which is an essential procedure for developing the field. Manipulators have played a role in benign tumors, but in surgery for malignant uterine tumors, manipulators are often avoided because they come into contact with the tumor, and as a result, it may be difficult to tow the uterus. This time, I have developed a new uterine traction method, so I would like to propose it.

Methodology The subjects were cases of endometrial cancer who underwent total hysterectomy with robot assisted. After approaching the abdominal cavity, cut the round ligament of the uterus, expand the broad ligament to the vicinity of the cervix, and perform the same operation on the left and right. Leave the proper ovarian ligament uncut. Cut the sterilized cotton tape to about 25 cm, wrap it around the cervix and ligate it. When pulling the uterus, hold this tape from the front and back of the uterus with the 3rd arm and pull it.

Abstract 2022-VA-1229-ESGO Figure 1
Abstract 2022-VA-1229-ESGO Figure 2

Results Since the cotton tape is wrapped around the center of gravity of the uterus, it is possible to stably pull the uterus in all directions and three-dimensionally.

Conclusion This method is easy to introduce and enables stable deployment of the surgical field. It also led to the effective use of human resources. It can be applied not only to malignant tumors but also to benign tumors and laparoscopic surgery.

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