Laparoscopic sterilization in the supine position using the Ramathibodi uterine manipulator.
OBJECTIVE
To investigate the usefulness of the Ramathibodi uterine manipulator (AMZURA Enterprises, Freeport, NY) in performing laparoscopic sterilization procedures in the supine position under local anesthesia.


METHODS
Descriptive prospective study.


METHODS
Ambulatory surgical unit of university-affiliated hospital.


METHODS
Women presenting for elective sterilization and weighing < 110 kg.


METHODS
The Ramathibodi uterine manipulator was used to provide uterine manipulation in 85 cases of laparoscopic sterilization, all performed in the supine position as local anesthesia-sedation sterilization operations. Because such procedures are becoming more common worldwide, we propose the acronym "LASSO" (Local Anesthesia-Sedation Sterilization Operation) for this class of operations. Although commonly used in minilaparotomy procedures, use of this uterine manipulation device in laparoscopic procedures has not been published previously.


METHODS
Successful tubal occlusion.


RESULTS
Among the 85 cases reported here there were no failures to manipulate the uterus successfully, to identify the tubes, and to occlude them.


CONCLUSIONS
The simplicity of the Ramathibodi uterine manipulator provided several advantages over other means of uterine manipulation, notably [1] constant easy-to-learn maneuvers, [2] no tenaculum or balloon requirement, [3] the procedure could be performed in the supine position, and [4] there are no working parts, screws, or springs that could be lost or broken by operating room staff. Our experience with this device leads us to recommend it to colleagues as an inexpensive, safe, and effective alternative to currently available instruments for providing uterine elevation during laparoscopic sterilization procedures.
Blumenthal
P D
PD
Johns Hopkins Bayview Medical Center, Department of Obstetrics and Gynecology, Baltimore, Maryland 21224, USA.
D000772:Anesthesia, Local; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008488:Medical Illustration; D011446:Prospective Studies; D013246:Sterilization, Tubal / Q000295:instrumentation* / Q000379:methods*; D016683:Supine Position