Efficacy of Uterine Manipulator in Total Abdominal Hysterectomy: A Triple-Blinded Randomized Controlled Trial
Surgical Innovation, cilt.32, sa.6, ss.507-512, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 6
- Basım Tarihi: 2025
- Doi Numarası: 10.1177/15533506251360840
- Dergi Adı: Surgical Innovation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.507-512
- Anahtar Kelimeler: hysterectomy, uterine manipulator, operative time, postoperative complications
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: The objective of this study was to investigate whether the advantages of uterine manipulators in laparoscopic hysterectomy could also be applied to abdominal hysterectomy. In the present study, we introduce a novel surgical technique that employs a uterine manipulator during open surgery and analyze the outcomes of this approach. Methods: A prospective, single-center, randomized controlled trial was conducted at a tertiary research hospital with patients who underwent hysterectomy for benign gynecological indications between October 2023 and March 2024. Patients were randomly assigned to either conventional abdominal hysterectomy or manipulator-assisted abdominal hysterectomy. Primary outcomes included operative time, with secondary outcomes including Visual Analog Scale (VAS) pain scores, intraoperative and postoperative complications, and length of hospital stay. Results: Among the 142 participants, the manipulator group exhibited a mean operative time of 92.2 ± 11.1 minutes compared to 107.6 ± 14.4 minutes in the control group (P < .001). Length of hospital stay was also significantly shorter in the manipulator group (42.3 ± 14.7 hours vs 47.4 ± 15.8 hours; P = .046). No significant differences were observed in postoperative complications or pain scores between groups. The mean postoperative hemoglobin decrease was significantly lower in the manipulator group (0.74 ± 0.28 g/dL) compared to the control group (1.52 ± 0.33 g/dL) (P < .001). Conclusion: The incorporation of a uterine manipulator in abdominal hysterectomy significantly reduces operative time, colpotomy time, and hospital stay while maintaining a comparable safety profile to conventional techniques. These findings suggest that uterine manipulators may enhance surgical efficiency and could be beneficial in clinical practice.