title: New techniques in radical hysterectomy.
abstract: OBJECTIVE
  To review the recent literature regarding modifications of abdominal radical hysterectomy as well as development of new approaches including laparoscopic, vaginal, and robotic radical hysterectomy.
  
  
  RESULTS
  Nerve-sparing radical hysterectomy technique allows for significant reduction in postoperative bladder morbidity. Radical vaginal hysterectomy with laparoscopic lymph node dissection is a well-recognized technique that offers excellent cure rates with absence of abdominal entry as well as reduced postoperative febrile and gastrointestinal morbidity. Total laparoscopic radical hysterectomy is a minimally invasive alternative to a traditional abdominal radical hysterectomy approach that yields comparable safety profile with a significant reduction in blood loss and hospital stay. Robotic surgery is becoming more widely accepted in the management of gynecologic cancers and larger series describing successful treatment of cervical cancer with robotic radical hysterectomy are soon to be published.
  
  
  CONCLUSIONS
  There are a number of approaches to performing radical hysterectomy. The feasibility and safety of these techniques have been well established. Preliminary oncologic outcome data are encouraging. The decision to utilize newer techniques depends on the patient and type of practice, as well as the surgeon's comfort level with laparoscopy, robotics, or vaginal surgery.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York 10029, USA. konstantin.zakashansky@mssm.edu
authors.forename: Konstantin
authors.initials: K
authors.lastname: Zakashansky
authors.forename: William H
authors.initials: WH
authors.lastname: Bradley
authors.forename: Farr R
authors.initials: FR
authors.lastname: Nezhat
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D012371:Robotics / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000601:surgery*