## 1 Introduction  
Minimally Invasive Surgery (MIS) has played an important role in healthcare for over two decades, promoting patient safety by significantly reducing the level of invasion, as the surgical end effectors are inserted through small incision ports. MIS can be used to treat a number of gynecologic conditions, in which the position of the uterus is essential [1]. Figure 1 illustrates how the operating theater for Laparoscopic Gynecologic Surgery is usually set up. The common setup comprises Surgeon (**S**), Patient (**P**), Nurse(**N**), Anesthetic (**A**) and Monitor (**M**) showing the image transferred from the laparoscope. Figure 1a,c show the setups for conventional laparoscopic surgery, in which **L**, representing the assistant holding and controlling the Laparoscopic, is necessary. Figure 1b,d are the setups of Robot-Assisted Surgery (RAS). This replaces **L**, with the robot depicted in the semi-sphere equipment here used to manipulate the scope. Unlike traditional open surgery, in laparoscopic gynecological surgery, the uterus is not controlled directly through small incisions. **U** in Figure 1a,b represents an assistant in charge of the uterine manipulation, whereas **R** represents the designed uterine manipulator robot, which can easily be applied to either conventional laparoscopic surgery or RAS, as shown in Figure 1c,d, respectively.  
To date, two approaches have been used to manipulate the uterus: abdominal control [2] and vaginal control, in compliance with the MIS scheme. In this approach, a uterine holder/manipulator, inserted through the patient's vulva, has become widely used, particularly during hysterectomies, as it offers several benefits to the laparoscopic surgeon due to the lateral mobilization of the uterus. In the last few decades, several new uterine manipulators have been developed. It has been stated [3] that the use of a uterine manipulator is one of the success factors for improving total laparoscopic hysterectomy (TLH). Uterine manipulation has evolved over the years. Initially, both the manipulation and holding of the uterine manipulator were performed manually; then, the uterine manipulation was performed by a human but an instrument held the manipulator itself [4; 5; 6; 7], finally, a robot performed the manipulation of the uterus and held the uterine manipulator. Examples of uterine manipulation robots can be seen in both the market and previous publications [8; 9; 10; 11; 12; 13; 14; 15; 16]. All of these robots were specifically built to carry out the entire process with a great deal of complexity.  
This study not only aims to implement a fatigue-free robotic uterine manipulation system which should be compatible with an existing and reusable uterine manipulator, but also seeks to achieve simplicity along with efficiency of implementation. Incorporating a familiar/existing uterine manipulator, the proposed system can be directly manipulated by the main surgeon to take up the task of uterus manipulation during laparoscopic gynecologic surgery.  
Figure 1: Diagrams of operating theater setups for conventional laparoscopic surgery in (**a,c**) and for RAS in (**b,d**) where in (**a,b**) is with an assistance holding the uterine manipulator and in (**c,d**) with a uterine manipulator robot.