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Minimally Invasive Surgery
Volume 2010 (2010), Article ID 836027, 5 pages
http://dx.doi.org/10.1155/2010/836027
Research Article

A Novel Technique of Uterine Manipulation in Laparoscopic Pelvic Oncosurgical Procedures: “The Uterine Hitch Technique”

Department of Minimally Invasive Oncology, Galaxy Laparoscopy Institute, Above Ayurved Rasashala, 25-A Karve Road, Pune, Maharashtra 411030, India

Received 23 July 2009; Accepted 26 November 2009

Academic Editor: Liselotte Mettler

Copyright © 2010 S. P. Puntambekar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To describe a new technique of uterine manipulation in laparoscopic management of pelvic cancers. Material and Methods. We used a novel uterine hitch technique in 23 patients from May 2008 to October 2008. These patients underwent pelvic oncologic surgery including laparoscopic radical hysterectomy ( ), laparoscopic anterior resection ( ), laparoscopic abdominoperineal resection ( ), laparoscopic posterior exenteration ( ), or laparoscopic anterior exenteration ( ). The uterus was hitched to the anterior abdominal.wall by either a single suture in the fundus or by sutures through the round ligaments. Results. The uterine hitch technique was successfully accomplished in all procedures. It was performed in less than 5 minutes in all cases. It obviated the need for vaginal manipulation. An extra port for retraction could be avoided. There were no intraoperative complications. Conclusion. A practical, cheap and reproducible method for uterine manipulation, during pelvic oncologic surgery is described. It improves the stability of the uterus and also obviates the need for keeping an additional assistant for vaginal manipulation in any of the procedures.