Step-by-Step Nerve-Sparing Radical Hysterectomy with Pelvic Lymphadenectomy

  • Shingo Fujii
  • Kentaro Sekiyama


However, each surgical procedure until the division of the deep uterine vein in the cardinal ligament is the same as that of the step-by-step radical hysterectomy without nerve-sparing radical hysterectomy as described in Chap.  5. Therefore, the detailed surgical procedure necessary for nerve-sparing radical hysterectomy shall start from the division of the cardinal ligament.


Paravesical space Pararectal space Cardinal ligament Deep uterine vein Pelvic splanchnic nerve Hypogastric nerve Anterior (ventral) leaf of the vesicouterine ligament Posterior (dorsal) leaf of the vesicouterine ligament Inferior hypogastric plexus (cross shaped) Bladder branch from the inferior hypogastric plexus Uterine branch from the inferior hypogastric plexus Paracolpium Division of the uterine branch only Division of the rectovaginal ligament T-shaped nerve plane Division of the paracolpium Nerve-sparing radical hysterectomy Good quality of life after radical hysterectomy 

Supplementary material

Video 8.1

Live surgical video 1: nerve-sparing radical hysterectomy by Shingo Fujii’s technique (85 minutes) (MP4 6192560 kb)

Video 8.2

Live surgical video 2: nerve-sparing radical hysterectomy by Shingo Fujii’s technique (95 minutes) (MP4 6851983 kb)

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Shingo Fujii
    • 1
  • Kentaro Sekiyama
    • 2
  1. 1.Department of Gynecology and ObstetricsKyoto UniversityKyotoJapan
  2. 2.Department of Obstetrics and GynecologyKitano HospitalKita-kuJapan

Personalised recommendations