• Christos Iavazzo and Ioannis D Gkegkes.
• IASO Maternity Hospital, 38, Seizani Str., Nea Ionia, 14231, Athens, Greece, christosiavazzo@hotmail.com.
• Arch. Gynecol. Obstet. 2013 Nov 1; 288 (5): 1003-9.

IntroductionThe evolution of minimally invasive surgery has been established and both laparoscopic- and robotic-assisted techniques can be presented as valuable alternatives to traditional approaches for the treatment of gynecological cancers, such as endometrial cancer. During laparoendoscopic procedures, the upward traction to the uterus is considered fundamental. The application of uterine manipulators in hysterectomy can facilitate diverse tasks to lead to a safe and successful surgical outcome. Some authors have raised their concern that the use of uterine manipulators might increase the incidence of tumor cell dissemination among patients with endometrial cancers.MethodsWe performed a literature search with terms related to the role of uterine manipulators in endometrial cancer recurrence in PubMed and Scopus.ResultsSix articles were identified dealing with this issue. Even though, the available clinical evidence suggests that the application of uterine manipulators has no clear correlation with the recurrence of the endometrial carcinoma, the existing trials are of low methodological quality.ConclusionFurther investigation is necessary for the clarification of the influence of the different types of uterine manipulators in cancer recurrence.

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