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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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