Study of Instillation Technique Using The Modified Intra- Uterine Manipulator Catheter With Methylene Blue, Isosulfan Blue or Indocyanine Green Dyes, Compared to Cervical Injection, For Sentinel Lymph Node Detection in Endometrial Carcinoma

Following consent, surgery will be determined by the physician thereby determining group assignment- i.e the laparoscopic surgery group oror the robotic assisted surgery group. Both groups will undergo SLN mapping by instillation and injection. The Laparotomy/Laparoscopy Group will have Lymphazurin by injection and instillation of methylene blue dye. The Robot Assisted Group will have ICG by injection and instillation of methylene blue. Patients will undergo total hysterectomy, bilateral salpingoophorectomy, pelvic and paraaortic lymphadenectomy through laparotomy, laparoscopic or robotic assisted surgery as clinically determined by their attending physician. Subjects will undergo this surgery whether or not enrolled in the study.

Any clinically indicated uterine manipulator will be acceptable. Potential subjects will be informed of the potential risks of this device so they may make an informed decision about participation in the study. However the manipulator is standard of care and is not a study related risk. Subjects who agree to this study procedure will be monitored for adverse events.

The dyes used in this study are commercially available and will be provided through internal funding from the CTCA Gynecology/Oncology Department. Potential subjects will be informed

of the potential risks of these drugs so they may make an informed decision about participation in the study. Subjects who agree to this study procedure will be monitored for adverse events.

After administration of anesthesia, the intra-uterine uterine manipulator catheter will be inserted using the following suggested instructions for use;