Laparoscopically assisted modified radical vaginal hysterectomy (type II) with pelvic lymphadenectomy: ultrasonic operative technique.
OBJECTIVE
The aim of this study was to incorporate an ultrasonic operative laparoscopic technique to complete a type II laparoscopically-assisted modified radical vaginal hysterectomy (LARVH) and pelvic lymph node dissection (PLND) in early cervical cancer.


METHODS
LARVH type II and PLND using a laparoscopic ultrasonic operative technique and conventional vaginal surgery were indicated in five cases of early cervical cancer (IA2).


RESULTS
Complete pelvic lymphadenectomy and the laparoscopic phase of modified radical vaginal hysterectomy were successfully performed using ultrasonic instruments in all women. Uterine artery and ureteral dissection with resection of the cervicovesical fascia, cardinal and uterosacral ligaments were successful with ultrasonically activated instruments only.


CONCLUSIONS
Our initial experience with laparoscopically assisted radical vaginal hysterectomy type II confirmed that the use of a minimally invasive ultrasonic technique is feasible. Further investigations into the indications of disease where laparoscopic surgery is appropriate in the management of early cervical carcinoma are required.
Holub
Z
Z
Department of Obstetrics and Gynaecology, Endoscopic Training Center, Baby Friendly Hospital, Kladno, Czech Republic.
Lukác
J
J
Kliment
L
L
Urbánek
S
S
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D010388:Pelvis; D010865:Pilot Projects; D014464:Ultrasonic Therapy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*