Designing and prototyping of a new uterine manipulator which will overcome drawbacks of conventional uterine manipulators and assist laparoscopic hysterectomies

Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operating time, lower post-operative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. During total laparoscopic hysterectomy, first uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely. Uterine manipulators are used during laparoscopy to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization which is difficult and hand skill required process, and amputation of the uterine cervix. A new transvaginal uterine manipulator may overcome these important drawbacks of these currently available devices. For this reason, a 3 dimensional (3D) scanning technique was used to obtain real world data such as uterine dimensions and computer aided design software is used in designing of the new manipulator and then 3D printer was used in prototyping. Special light emitting diodes (LEDs) were mounted on the cervical cap of the manipulator to guide light beams from inside of cervicovaginal tissue to abdominal cavity to facilitate the visualization of tissue landmarks. In brief, structural synthesis, CAD and rapid prototyping of parallel manipulator with 2-dof and which allows the uterus to be manipulated in both anterior posterior and lateral axis was performed in the scope of this thesis. Furthermore, a circular LED system was designed and implemented on system to ease the determination of cervicovaginal landmark. In the light of the findings acquired from the study, designed manipulator has ability to manipulate uterus in anterior posterior and lateral axis. Moreover, LED illumination system which can be detected easily by the laparoscope is successfully implemented on the manipulator's cervical cap.