Page 14 - Journal of WALS

Meenakshi Jain

Fig. 5: Positioning of the arms prior to docking Fig. 8: Right side view of docked 1st and 3rd arm

Fig. 6: Positioning of the arms after docking Fig. 9: Usual port placement in Jain technique

It offers full anteversion, retroversion and lateral
positioning. Articulates at the cervix to provide extreme
uterine mobility and traction in any direction. The Koh’s
rings make it much easier to do colpotomy anteriorly and
posteriorly. L-shaped locking handle permits repositioning
from the surgical field for complete access.
A starter pack which includes the handle and enough
tips to perform 10 procedures is offered.
It is very beneficial when used for myomectomies,
specially with the Rumi positioning system which is attached
to the bed and maintains the position of the uterus. This
reduces assistant exhaustion, which often prevents the
Fig. 7: View of the docked robot from the head of the patient assistant from pushing the uterus superiorly.
The Rumi retractor (Fig. 11) has an elbow which I
believe delineates the fornices very clearly and makes
UTERINE MANIPULATION BY RUMI the incision for colpotomy much easier to make compared
POSITIONING SYSTEM to other manipulators. I do not suture the Rumi to the
Every surgeon has his or her preferences for using particular cervix.
instruments. I have used a Rumi intrauterine manipulator In addition to using the Rumi I also believe it is important
in all my cases and feel that it is an integral part of my to make sure the assistant who manipulates the uterus is
surgical technique (Fig. 10). I feel it delineates the anatomy pushing the uterus very firmly. Pushing the uterus superiorly
better for me than any other uterine manipulator. will reduce the chances of injury to ureters and the bladder.
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JAYPEE