Novel Colpotomizer Helps Prevent Injury During Laparoscopic Hysterectomies

Use of the system is indicated when uterine manipulation and visualization of the vaginal fornices is needed to access or remove intraperitoneal tissue by anterversion and retroversion of the uterus. This provides a landmark for vaginal vault incision, and helps maintain pneumoperitoneum patency with a vaginal plug placed behind the funnel, if a CO2 leak is anticipated during the colpotomy itself and vaginal vault closure.

The system is comprised of a reusable uterine manipulator with cervical screw attachment, a reusable sliding uterine tip (inner rod), reusable sliding and rotating funnels (available in both 35 mm and 40 mm sizes) with a lip acting as a colpotomizer, an 0-ring and screw to hold the funnel in place. Both straight and curved inner rods (adjustable and retractable to fit all uterine lengths) are available, while the rotatable colpotomizer lip ensures consistent ureteric displacement. Various sized probes are available for tissue collection in both regular and nulliparous vaginas before vault closure. The Singh Colpotomizer System is a product of SurgiTools (Woodvale, Australia), and has been approved by the US Food and Drug Administration (FDA).

Colpotomy is a minimally invasive transvaginal sterilization procedure, which tends to be reserved for obese patients or for women with a retroverted uterus. During the procedure, an incision is made into the posterior vaginal fornix. The surgeon then inserts an intrauterine sound through the incision into the peritoneal cavity, which helps to manipulate the uterus and bring the fallopian tubes to view. The tubes are brought out through the incision, into the vagina, where they are closed off and put back into place; the incision is then stitched shut.

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