A new approach to treatment of early-stage cervical carcinoma: entire laparoscopic abdominal radical hysterectomy with bilateral pelvic lymphadenectomy without vaginal cuff closure--case reports.
OBJECTIVE
The objective of this study is to describe a new technique of laparoscopic radical hysterectomy without vaginal cuff closure.


METHODS
Three patients underwent laparoscopic radical hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic lymph node dissection using an Argon Beam Coagulator. Four trocars were used: umbilical port for the camera, two ports for the operating surgeon and a fourth port for use by the surgical assistant.


RESULTS
All patients were clinically staged IB1. Ages were 53, 64 and 58 and BMI was 19.5, 25.2 and 21.4, respectively. Duration of surgery was 375, 325 and 335 minutes, respectively, from first trocar insertion to last closing stitch. Estimated blood loss was 300, 100 and 400 ml and removed pelvic lymph nodes 18, 15 and 26, respectively. The patients tolerated the surgical technique and recovered satisfactorily.


CONCLUSIONS
These are the first three cases of early-stage cervical carcinoma patients who have been treated with entirely laparoscopic abdominal radical hysterectomy (LARH) and bilateral pelvic lymphadenectomy (BPL) without vaginal cuff closure. To our knowledge, this has not been previously described in the literature. It is feasible and was well tolerated in this small series of patients.
Sert
B
B
Department of Gynecologic Oncology, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway.
Abeler
V M
VM
Dørum
A
A
Trope
C G
CG
D000230:Adenocarcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000601:surgery*