Advertisement

Hysterectomy pp 597-609 | Cite as

Laparoscopic Radical Hysterectomy with Pelvic Lymphadenectomy (Spanish School)

  • Antonio Gil-MorenoEmail author
  • Sabina Salicrú
  • Berta Diaz-Feijoo
  • Blanca Gil-Ibáñez
Chapter
  • 711 Downloads

Abstract

Laparoscopic radical hysterectomy is one of the surgical procedures performed today in the management of gynecologic cancer. The term radical hysterectomy has been used to refer to a wide range of procedures that act with different degrees of radicality. In 1974, in western countries, Piver and Rutledge described five different types of extended abdominal radical hysterectomy and a new classification was recently proposed by Querleu and Morrow in 2008.

The laparoscopic approach is associated with a lower surgical morbidity in terms of surgical bleeding and shorter length of hospital stay, although the duration of the operation may be longer if the team is not well trained. Laparoscopic radical hysterectomy with endoscopic pelvic lymphadenectomy (and paraaortic lymphadenectomy if needed) is a safe surgical option for the treatment and staging of early invasive cervical cancer regarding technique, surgical risk, intraoperative bleeding, intra-and postoperative complications, and patient’s recovery. It is important to consider the learning curve. Surgical advances including new laparoscopic instrumentation and particularly, the use of robotics, will contribute to reducing the duration of operations and facilitate the learning and teaching of the procedure.

Keywords

Laparoscopic radical hysterectomy Laparoscopic pelvic lymphadenectomy Early cervical cancer-surgical morbidity-minimally invasive surgery 

References

  1. 1.
    Querleu D, Leblanc E, Castelain B. Laparoscopic pelvic lymphadenectomy in the staging of early carcinoma of the cervix. Am J Obstet Gynecol. 1991;164:579–81.CrossRefPubMedGoogle Scholar
  2. 2.
    Leblanc E, Querleu D, Castelain B, et al. Bilan de la cœliochirurgie en oncologie gynécologique en 2000. Bull Cancer. 2000;87:76–85.PubMedGoogle Scholar
  3. 3.
    Reich H, DeCaprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg. 1989;5:213–6.CrossRefGoogle Scholar
  4. 4.
    Dargent D, Mathevet P. Hystérectomie élargie laparoscopico-vaginale. J Gynecol Obstet Biol Reprod (Paris). 1992;21:709–10.Google Scholar
  5. 5.
    Querleu D. Hystérectomies élargies de Schauta-Amreich et Schauta-Stoeckel assistées par cœlioscopie. J Gynecol Obstet Biol Reprod. 1992;20:747–8.Google Scholar
  6. 6.
    Querleu D. Laparoscopically assisted radical vaginal hysterectomy. Gynecol Oncol. 1993;51:248–54.CrossRefPubMedGoogle Scholar
  7. 7.
    Canis M, Mage G, Wattiez A, JL P, Manhes H, MA B. La chirurgie endoscopique a-t-elle une place dans la chirurgie radicale du cancer du col utérin? J Gynecol Obstet Biol Reprod (Paris). 1990;19:921.Google Scholar
  8. 8.
    Nezhat CR, Burrell MO, Nezhat FR, Benigno BB, Welander CE. Laparoscopic radical hysterectomy with paraaortic and pelvic node dissection. Am J Obstet Gynecol. 1992;166:864–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Canis M, Mage G, Pouly JL, et al. Laparoscopic radical hysterectomy for cervical cancer. Baillieres Clin Obstet Gynaecol. 1995;9:675–89.CrossRefPubMedGoogle Scholar
  10. 10.
    Hsieh YY, Lin WC, Chang CC, Yeh LS, Hsu TY, Tsai HD. Laparoscopic radical hysterectomy with low paraaortic, subaortic and pelvic lymphadenectomy. Results of short-term follow-up. J Reprod Med. 1998;43:528–34.PubMedGoogle Scholar
  11. 11.
    Sedlacek TV, Campion MJ, Hutchins RA, Reich H. Laparoscopic radical hysterectomy: a preliminary report [abstract]. J Am Assoc Gynecol Laparosc. 1994;1(Part 2):s32.CrossRefPubMedGoogle Scholar
  12. 12.
    Kim DH, Moon JS. Laparoscopic radical hysterectomy with pelvic lymphadenectomy for early, invasive cervical carcinoma. J Am Assoc Gynecol Laparosc. 1998;5:411–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Spirtos NM, Schlaerth JB, Kimball RE, Leiphart VM, Ballon SC. Laparoscopic radical hysterectomy (type III) with aortic and pelvic lymphadenectomy. Am J Obstet Gynecol. 1996;174:1763–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Mutch DG. The new FIGO staging system for cancers of vulva, cervix, endometrium and sarcomas. Gynecol Oncol. 2009;115:325–8.CrossRefGoogle Scholar
  15. 15.
    Piver MS, Rutledge F, Smith JP. Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol. 1974;44:265–72.PubMedGoogle Scholar
  16. 16.
    Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303.CrossRefPubMedGoogle Scholar
  17. 17.
    Cibula D, Abu-Rustum NR, Benedetti-Panici P, Köhler C, Raspagliesi F, Querleu D, Morrow CP. New classification system of radical hysterectomy: emphasis on a three-dimensional anatomic template for parametrial resection. Gynecol Oncol. 2011;122:264–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Gil-Moreno A, Puig O, Pérez-Benevente MA, et al. Total laparoscopic radical hysterectomy (type II-III) with pelvic lymphadenectomy in early invasive cervical cancer. J Minim Invasive Gynecol. 2005;12:113–20.CrossRefPubMedGoogle Scholar
  19. 19.
    Lin YS. Preliminary results of laparoscopic modified radical hysterectomy in early invasive cervical cancer. J Am Assoc Gynecol Laparosc. 2003;10:80–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Abu-Rustum NR, Gemignani ML, Moore K, et al. Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: pilot data and comparison to laparotomy. Gynecol Oncol. 2003;91:402–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Zakashansky K, Chuang L, Gretz H, Nagarsheth NP, Rahaman J, Nezhat FR. A case-controlled study of total laparoscopic radical hysterectomy with pelvic lymphadenectomy versus radical abdominal hysterectomy in a fellowship training program. Int J Gynecol Cancer. 2007;17:1075–82.CrossRefPubMedGoogle Scholar
  22. 22.
    Li G, Yan X, Shang H, Wang G, Chen L, Han Y. A comparison of laparoscopic radical hysterectomy and pelvis lymphadenectomy and laparotomy in the treatment of Ib-IIa cervical cancer. Gynecol Oncol. 2007;105:176–80.CrossRefPubMedGoogle Scholar
  23. 23.
    Frumovitz M, dos Reis R, Sun CC, et al. Comparison of total laparoscopic and abdominal radical hysterectomy for patients with early-stage cervical cancer. Obstet Gynecol. 2007;110:96–102.CrossRefPubMedGoogle Scholar
  24. 24.
    Frumovitz M, Ramirez PT. Total laparoscopic radical hysterectomy: surgical technique and instrumentation. Gynecol Oncol. 2007;104(Suppl):13–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Díaz-Feijoó B, Gil-Moreno A, Pérez-Benavente A, Morchón S, Martínez-Palones JM, Xercavins J. Sentinel lymph node identification and radical hysterectomy with lymphadenectomy in early stage cervical cancer: laparoscopy versus laparotomy. J Minim Invasive Gynecol. 2008;15:531–7.CrossRefPubMedGoogle Scholar
  26. 26.
    Malzoni M, Tinelli R, Cosentino F, Fusco A, Malzoni C. Total laparoscopic radical hysterectomy versus abdominal radical hysterectomy with lymphadenectomy in patients with early cervical cancer: our experience. Ann Surg Oncol. 2009;16:1316–23.CrossRefPubMedGoogle Scholar
  27. 27.
    Ditto A, Martinelli F, Bogani G, Gasparri ML, Di Donato V, Zanaboni F, Lorusso D, Raspagliesi F. Implementation of laparoscopic approach for type B radical hysterectomy: a comparison with open surgical operations. Eur J Surg Oncol. 2015;41:34–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Gil-Moreno A, Díaz-Feijoo B, Roca I, et al. Total laparoscopic radical hysterectomy with intraoperative sentinel node identification in patients with early invasive cervical cancer. Gynecol Oncol. 2005;96:187–93.CrossRefPubMedGoogle Scholar
  29. 29.
    Pomel C, Atallah D, Le Bouedec G, et al. Laparoscopic radical hysterectomy for invasive cervical cancer: 8-year experience of a pilot study. Gynecol Oncol. 2003;91:534–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Sedlacek TV, Campion MJ, Reich H, Sedlacek T. Laparoscopic radical hysterectomy: a feasibility study. Gynecol Oncol. 1995;56:126 (abstract 65).Google Scholar
  31. 31.
    Ramirez PT, Slomovitz BM, Soliman PT, Coleman RL, Levenback C. Total laparoscopic radical hysterectomy and lymphadenectomy: The MD Anderson Cancer Center experience. Gynecol Oncol. 2006;102:252–5.CrossRefPubMedGoogle Scholar
  32. 32.
    Jobling T, Wood C. Laparoscopic modified radical hysterectomy and lymphadenectomy simulating open operation for stage 1A2 cervical carcinoma. Aust N Z J Obstet Gynaecol. 1993;33:400–3.CrossRefPubMedGoogle Scholar
  33. 33.
    Spirtos NM, Eisenkop SM, Schlaerth JB, Ballon SC. Laparoscopic radical hysterectomy (type III) with aortic and pelvic lymphadenectomy in patients with stage I cervical cancer: Surgical morbidity and intermediate follow-up. Am J Obstet Gynecol. 2002;187:340–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Suprasert P, Charoenkwan K, Khunamornpong S. Pelvic node removal and disease-free survival in cervical cancer patients treated with radical hysterectomy and pelvic lymphadenectomy. Int J Gynecol Obstet. 2012;116:43–6.CrossRefGoogle Scholar
  35. 35.
    Shah M, Lewin SN, Deutsch I, et al. Therapeutic role of lymphadenectomy for cervical cancer. Cancer. 2011;117:310–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, Heintz AP, Ngan HY, Sideri M, Pecorelli S. Carcinoma of the cervix uteri. J Epidemiol Biostat. 2001;6:7–43.PubMedGoogle Scholar
  37. 37.
    Robison K, Holman LL, Moore RG. Update on sentinel lymph node evaluation in gynecologic malignancies. Curr Opin Obstet Gynecol. 2011;23(1):8–12.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Achouri A, Huchon C, Bats AS, Bensaid C, Nos C, Lécuru F. Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol (EJSO). 2013;39(1):81–6.CrossRefGoogle Scholar
  39. 39.
    Eiriksson L, Covens A. Sentinel lymph node mapping in cervical cancer: the future? BJOG Int J Obstet Gynaecol. 2012;119(2):129–33.CrossRefGoogle Scholar
  40. 40.
    Lambaudie E, Collinet P, Narducci F, Sonoda Y, Papageorgiou T, Carpentier P, Leblanc E, Querleu D. Laparoscopic identification of sentinel lymph nodes in early stage cervical cancer: prospective study using a combination of patent blue dye injection and technetium radiocolloid injection. Gynecol Oncol. 2003;89:84–7.CrossRefPubMedGoogle Scholar
  41. 41.
    Xu H, Chen Y, Li Y, Zhang Q, Wang D, Liang Z. Complications of laparoscopic radical hysterectomy and lymphadenectomy for invasive cervical cancer: experience base on 317 procedures. Surg Endosc. 2007;21:960–4.CrossRefPubMedGoogle Scholar
  42. 42.
    Puntambekar SP, Palep RJ, Puntambekar SS, et al. Laparoscopic total radical hysterectomy by the Pune technique: our experience of 248 cases. J Minim Invasive Gynecol. 2007;14:682–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Uccella S, Laterza R, Ciravolo G, et al. A comparison of urinary complications following total laparoscopic radical hysterectomy and laparoscopic pelvic lymphadenectomy to open abdominal surgery. Gynecol Oncol. 2007;107:S147–9.CrossRefPubMedGoogle Scholar
  44. 44.
    Pellegrino A, Vizza E, Fruscio R, et al. Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in patients with Ib1 stage cervical cancer: analysis of surgical and oncological outcome. EJSO. 2009;35:98–103.CrossRefPubMedGoogle Scholar
  45. 45.
    Wexner SD, Bergamaschi R, Lacy A, et al. The current status of robotic pelvic surgery: results of a multinational interdisciplinary consensus conference. Surg Endosc. 2009;23:438–43.CrossRefPubMedGoogle Scholar
  46. 46.
    Sert BM, Abeler VM. Robotic-assisted laparoscopic radical hysterectomy (Piver type III) with pelvic node dissection—case report. Eur J Gynaecol Oncol. 2006;27:531–3.PubMedGoogle Scholar
  47. 47.
    Magrina JF, Zanagnolo VL. Robotic surgery for cervical cancer. Yonsei Med J. 2008;49:879–85.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Ramirez PT, Soliman PT, Schmeler KM, dos Reis R, Frumovitz M. Laparoscopic and robotic techniques for radical hysterectomy in patients with early-stage cervical cancer. Gynecol Oncol. 2008;110:S21–4.CrossRefPubMedGoogle Scholar
  49. 49.
    Nezhat FR, Datta MS, Liu C, Chuang L, Zakashansky K. Robotic radical hysterectomy versus total laparoscopic radical hysterectomy with pelvic lymphadenectomy for treatment of early cervical cancer. JSLS. 2008;12:227–37.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Gil-Ibáñez B, Díaz-Feijoo B, Pérez-Benavente A, Puig-Puig O, Franco-Camps S, Centeno C, Xercavins J, Gil-Moreno A. Nerve sparing technique in robotic-assisted radical hysterectomy: results. Int J Med Robot. 2013;9(3):339–44.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  • Antonio Gil-Moreno
    • 1
    Email author
  • Sabina Salicrú
    • 1
  • Berta Diaz-Feijoo
    • 1
  • Blanca Gil-Ibáñez
    • 1
  1. 1.Department of Obstetrics and GynecologyHospital Universitari Vall d’Hebron Universitat Autònoma de BarcelonaBarcelonaSpain

Personalised recommendations