Abdominal radical hysterectomy and bilateral pelvic lymph node dissections for cancer of the cervix. The Okabayashi operation its modifications.
The original Wertheim operation for cancer of the cervix has been modified by Latzko, Okabayashi, Meigs and other gynecologist. The modified methods are called the extended Wertheim methods or the Latzko-Okabayashi-Meigs operation. Although the sequence of the operative steps differs, the Latzko and the Okabayashi operations are similar in the exposure of the spaces between the three main sections of taut connective tissue which supports the organs of the small pelvis. By contrast, both methods differ in the divisions of the superficial and deep layers of the vesicouterine ligament. The procedure for resection of the vesicouterine ligament described by Okabayashi, especially for complete separation of the deep layer of the ligament, enables to perform an extensive resection of the vesicouterine ligament and the lateral paravaginal tissue and to transect the vagina sufficiently at the required level as far as necessary. The present paper describes the original and modified Okabayashi operation in comparison with the extended Wertheim methods by Latzko and Meigs.
D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D002583:Uterine Cervical Neoplasms / Q000601:surgery*