The role of uterine manipulators in endometrial cancer recurrence after laparoscopic or robotic procedures.
BACKGROUND
The evolution of minimally invasive surgery has been established and both laparoscopic- and robotic-assisted techniques can be presented as valuable alternatives to traditional approaches for the treatment of gynecological cancers, such as endometrial cancer. During laparoendoscopic procedures, the upward traction to the uterus is considered fundamental. The application of uterine manipulators in hysterectomy can facilitate diverse tasks to lead to a safe and successful surgical outcome. Some authors have raised their concern that the use of uterine manipulators might increase the incidence of tumor cell dissemination among patients with endometrial cancers.


METHODS
We performed a literature search with terms related to the role of uterine manipulators in endometrial cancer recurrence in PubMed and Scopus.


RESULTS
Six articles were identified dealing with this issue. Even though, the available clinical evidence suggests that the application of uterine manipulators has no clear correlation with the recurrence of the endometrial carcinoma, the existing trials are of low methodological quality.


CONCLUSIONS
Further investigation is necessary for the clarification of the influence of the different types of uterine manipulators in cancer recurrence.
IASO Maternity Hospital, 38, Seizani Str., Nea Ionia, 14231, Athens, Greece, christosiavazzo@hotmail.com.
Christos
C
Iavazzo
Ioannis D
ID
Gkegkes
D002277:Carcinoma / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000295:instrumentation; D010535:Laparoscopy / Q000009:adverse effects* / Q000295:instrumentation; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012371:Robotics / Q000295:instrumentation