title: Nerve sparing technique in robotic-assisted radical hysterectomy: results.
abstract: BACKGROUND
  This work assessed the role of robotic-assisted lapararoscopic radical hysterectomy in the treatment of early invasive cervical cancer with special regard to nerve sparing technique.
  
  
  METHODS
  Between October 2009 and June 2011, a total of 14 non-consecutive patients underwent early cervical cancer surgery at the authors' institution. Patients with FIGO stage IA2 or IB1 with a tumor size less than or equal to 2 cm underwent radical hysterectomy type B1 and patients with FIGO stage IB1 with a tumor mass bigger than 2 cm underwent a radical hysterectomy using a C1 type technique.
  
  
  RESULTS
  Three type B1 and 11 type C1 radical hysterectomies with robotic-assisted laparoscopy were performed using Da Vinci®. The median operation time was 260 min (range 150-300 min). The median follow-up after surgery was 13.7 months (range 1-23 months). During this time, three patients reported anorectal dysfunction while none reported sexual or bladder dysfunction. All patients remain without evidence of disease except one with high risk factors for recurrence. They all are alive.
  
  
  CONCLUSIONS
  Laparoscopic robotic-assisted radical hysterectomy with nerve sparing technique is an attractive surgical approach for early invasive cervical cancer. Robotic technology allows a stereoscopic visualization of blood vessels and autonomic nerve supplies (sympathetic and parasympathetic branches) to the bladder and rectum making nerve sparing a safe and feasible procedure.
authors.affiliation: Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Gil-Ibáñez
authors.forename: Berta
authors.initials: B
authors.lastname: Díaz-Feijoo
authors.forename: Asunción
authors.initials: A
authors.lastname: Pérez-Benavente
authors.forename: Oriol
authors.initials: O
authors.lastname: Puig-Puig
authors.forename: Silvia
authors.initials: S
authors.lastname: Franco-Camps
authors.forename: Cristina
authors.initials: C
authors.lastname: Centeno
authors.forename: Jordi
authors.initials: J
authors.lastname: Xercavins
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil-Moreno
mesh_terms: D000328:Adult; D000368:Aged; D017776:Autonomic Pathways / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D010388:Pelvis / Q000294:innervation; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: cervical cancer; nerve sparing; radical hysterectomy; robotic surgery