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Autocalve, Sterilizable

Compared with most of the other commercially available uterine manipulator types, the HOHL uterine manipulator has a simple appearance. The lines are straight and the forward end has a sharp, spiral-thread tip designed to be screwed into the endocervical canal to secure the device onto the cervix. The HOHL comes with several different-sized tips, screws, and cups to accommodate a wide range of anatomic variation and the manipulator is easy to assemble and disassemble. The cervical cups are ceramic, making them sturdy and electrocautery and harmonic compatible.

In clinical testing during a robotic total hysterectomy, the HOHL uterine manipulator performed excellently. The device was easy to secure to the cervix and held the cup at the vaginal fornices with a tight seal that nicely delineated the anatomy during surgery. The ceramic cup was comfortable to cut against and the length of the cup was adequate to maintain a reasonable pneumoperitoneum after the colpotomy was made, although there was some air leakage.

Uterine manipulators are frequently used in simple and radical hysterectomies and are beneficial in improving visualization and providing a landmark for the colpotomy. A variety of manipulators are available and can be tailored to the planned procedure. If a colpotomy is planned, manipulators with a cup to fit over the cervix are preferred; these include the RUMI in conjunction with KOH cups. If the patient has already had a hysterectomy and delineation of the vaginal cuff is required, vaginal probes can be used. If the manipulator is being placed purely to move the uterus, a Hulka tenaculum  can be used.

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Autocalve, Sterilizable

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The Clermont Ferrand Uterine Manipulator is a specialized laparoscopic instrument designed for total laparoscopic hysterectomy (TLH), colpotomy, and complex gynecological procedures. As a cornerstone of modern minimally invasive surgery, its intended use is to provide surgeons with superior control over the uterus, allowing for precise positioning and optimal exposure of the pelvic anatomy.

Functions and Clinical Indications

This instrument functions as a multi-axial lever, enabling the surgical team to manipulate the uterus in anteversion, retroversion, and lateral directions. Key indications include:

• Total Laparoscopic Hysterectomy (TLH): Providing a clear landmark for colpotomy.

• Endometriosis Resection: Shifting the uterus to access the Pouch of Douglas.

• Myomectomy: Stabilizing the uterine wall during fibroid removal.

Technical Features and Materials

The GERATI Clermont Ferrand Uterine Manipulator is manufactured from medical-grade 304 and 410 stainless steel, ensuring high tensile strength and complete resistance to the rigors of repeated sterilization.

• 0° to 90° Deflection: Provides a wide range of motion for complex pelvic angles.

• Trumpet Style Handle: Ergonomically designed for one-handed operation.

• Ceramic Vaginal Pipes: Included to ensure safe electrosurgical insulation during colpotomy.

• Autoclavable Design: Fully reusable, meeting global sterilization standards.

Advantages for Surgeons and Clinics

Choosing the Clermont Ferrand Uterine Manipulator offers several clinical advantages:

1. Enhanced Safety: The precise colpotomy rim prevents ureteral injury by clearly defining the vaginal vault.

2. Pneumoperitoneum Maintenance: The anatomical design prevents gas leakage during vaginal incisions.

3. Cost-Efficiency: Unlike disposable alternatives, this stainless steel instrument provides years of service, reducing the per-procedure cost for hospitals and distributors.

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