Design: Through a review of the literature, we identified studies that assess the use of different uterine manipulators to discuss use of the Hohl uterine manipulator as compared to other commonly used manipulators. The main results of this literature review are highlighted in this video.

Setting: Using video footage obtained in the operating room, we demonstrate the use of the Hohl manipulator in vivo at total laparoscopic hysterectomy.

Patients or Participants: Video footage was obtained during three patients’ surgeries. All patients provided preoperative consent for capture of photos and video.

Interventions: In this video, we address the challenges associated with assembly of the Hohl manipulator by providing a step-by-step demonstration of its assembly, insertion, and manipulation. We also demonstrate the assembly and insertion of the cancer tip attachment for organ preserving surgeries in patients with uterine/cervical cancer or pre-cancer.

Measurements and Main Results: The Hohl uterine manipulator is the most studied uterine manipulator and has been highlighted as easy to handle, although difficult to assemble. In a randomized controlled trial the Hohl manipulator was demonstrated to facilitate shorter time from skin incision to uterine detachment as compared to the colpo probe manipulator.

Conclusion: The Hohl uterine manipulator can facilitate expeditious skin to uterine detachment time at total laparoscopic hysterectomy. We anticipate that this video will help surgeons to safely and efficiently place the Hohl uterine manipulator.