4.1 Main findings
We demonstrated that the use of IU manipulators did not result in poorer
oncological outcome than the use of non-IU manipulators during TLH in
early-stage, low-grade EEC in a longitudinal and nationwide study in the
Netherlands. No differences were observed between IU and non-IU
manipulators in recurrence, DFS, and OS. Secondarily, no
association was found between site of recurrence and type of
manipulator. However, manipulator preferences differed significantly by
type of hospital. Non-IU manipulators were predominantly used in
academic hospitals, whereas IU manipulators were mostly used in general
and teaching hospitals. Our survey also revealed that these preferences
changed within some hospitals over the years.