Use of the uterine manipulator in minimally invasive surgery for endometrial cancer. Oncological outcomes

Objective: To analyse the differences in oncological outcomes in patients operated for endometrial cancer based on the use of a uterine manipulator. Methods: Retrospective study of patients underwent surgery for endometrial carcinoma in a single centre, a tertiary hospital that has a gynaecological oncology unit. Data were collected from patients undergoing minimally invasive surgery for endometrial carcinoma in the period between January 1, 2010 and December 31, 2020. The sample was divided into two groups: Group A, made up of patients in whom a uterine manipulator was used during surgery, and Group B, made up of women in whom no manipulator was used. Results: We included 279 patients with minimally invasive approach (either laparoscopic surgery or robotic surgery). In 232 patients (Group A, 83,1%), a uterine manipulator, V-Care was used, while in 47 patients (Group B, 16.9%) the manipulator was not used. No differences were observed in oncological outcomes between the groups (Disease Free Survival [DFS] 39,1 months in Group A and 39,0 months in Group B). Conclusion: Our results confirm that the uterine manipulator can be used safely during surgery for endometrial carcinoma. *Correspondence to: Iñaki Lete, MD, Obstetrics and Gynaecology Clinical Management Unit, Araba University Hospital, José Atxotegi s/n. 01009 Vitoria, Spain, E-mail: luisignacio.letelasa@osakidetza.eus