Purpose This review aims to objectively assess the efficacy\nand safety of uterine manipulators as reported in\nscientific literature. Furthermore, it evaluates as to which\nmanipulator best suits which surgical procedure.\nMethods PubMed, Embase,Web of Science,COCHRANE,\nCINAHL, Academic Search Premier, Science Direct and the\nMAUDE database were searched. Technical information was\nretrieved from the manufacturers.\nResults 25 articles covering 10 uterine manipulators were\nfound. Studies regarding implementation and use of manipulators\nare scarce; only two surveys were found comparing\ndifferent manipulators. Moreover, clinical evidence\nproving the efficacy of manipulators with respect to prevention\nof complications, inherent to laparoscopic surgery,\ndoes not exist.\nConclusion The use of uterine manipulators is well\nestablished and it is clear that uterine manipulators offer\nthe easiest way to handle the uterus during surgery. However,\ndetailed information regarding efficacy and safety is\nscarce. Clinical evidence substantiating the assumed\nmechanism of prevention of ureter injuries was not found.\nOur review did not find the optimal manipulator. Some are\nmore versatile than others and not all instruments are appropriate\nfor all types of surgery. Therefore, gynecologists\nshould choose the manipulator that best suits the type of\nsurgery that is performed.
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