Songkla uterine manipulator.

ABSTRACT

The Songkla Uterine Manipulator (SUM) was developed for laparoscopic procedures. Its shaft consists of two stainless steel rods, which pivot a head and locking system. The obturator has a plate and is connected to the pivot head with a screw. The obturator has a diameter of 4.7 mm with three standard lengths of 6, 8, and 10 cm and there is a spring hook to retain it with the tenaculum. The SUM allows antevertion of the uterus up to 95 degrees and lateral motion of about 45 degrees bilaterally. From December 1996 to December 1999, the SUM was used successfully in 150 laparoscopic procedures, including 51 tubal sterilizations, 42 cases of adnexal surgery, 12 total laparoscopic hysterectomies and 45 laparoscopic assisted vaginal hysterectomies. The visualization of pelvic organs including both adnexae was good in all cases without trauma to the vagina, cervix or uterus. Conclusion: The simplified low cost uterine manipulator was developed. Early results were good but more modifications are needed, such as mechanism to retain it to the cervix without the tenaculum and sealing of gas leakage from the vagina during laparoscopic hysterectomy.