Obstet Gynecol Sci.  2017 Jan;60(1):110-114. 10.5468/ogs.2017.60.1.110.

Laparoendoscopic single-site radical hysterectomy for early stage cervical cancer

• Park JY
• Kim YM
• Lee YY
• Kim TJ
• Lee JW
• Kim BG
• Bae DS
• Choi CH

• KMID: 2383217
• DOI: http://doi.org/10.5468/ogs.2017.60.1.110

Abstract

Technical developments have made laparoendoscopic single-site (LESS) surgery increasingly more feasible for treating gynecological conditions, including cancer. However, complex surgeries such as radical hysterectomy have rarely been performed with single-port access because of technical difficulties. The majority of the difficulties are due to the inefficient retraction of tissue during dissection. Here, we report a detailed description of LESS radical hysterectomy plus pelvic lymph node dissection that was successfully performed in two patients with stage IB1 cervical cancer. We used our expertise with LESS to perform space development as much as possible before the ligaments were resected. The oncologic clearance was comparable to that of conventional laparoscopic radical hysterectomy.

Keyword

Radical hysterectomy; Single-site surgery; Uterine cervical neoplasms

MeSH Terms

Humans
Hysterectomy*
Ligaments
Lymph Node Excision
Uterine Cervical Neoplasms*

Figure

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  Fig. 1 (A) Identification of the uterine artery and ureter. (B) Broad ligament suture for approximation. (C) Round ligament and anterior peritoneum in situ. (D) Lateral displacement of the ureter.

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  Fig. 2 (A) Lateral displacement of ureter. (B,C) Ureter freed from paracolpos. (D) After pelvic lymphadenectomy and uterus removal followed by vault closure vaginally.

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