title: The Wertheim hysterectomy: Development, modifications, and impact in the present day.
abstract: Ernst Wertheim was a pioneer in the history of the surgical treatment of cervical cancer. His English-language manuscript "The extended abdominal operation for carcinoma uteri (based on 500 operative cases)," which was published in 1912, detailed his standardization of the radical hysterectomy and formed the basis of the current treatment for early stage cervical cancer. We contextualize the Wertheim hysterectomy, emphasizing medical advances that allowed for its development and subsequent modification. We then discuss modifications to the originally proposed procedure, including a maximally extended parametrical resection pioneered by Takayama, and the addition of the Taussig en bloc lymph node dissection by Meigs, both of which afforded an improved mortality profile due to decreased disease recurrence. Finally, we discuss progress that has been made in the present day, such as the development of nerve-sparing and fertility-sparing surgeries, as well as the introduction of the robotic platform. In this way, we hope to provide a historical background for the Wertheim hysterectomy-a cornerstone of gynecologic oncology.
authors.affiliation: Pennsylvania State University College of Medicine, Hershey, PA, United States. Electronic address: aswailes@pennstatehealth.psu.edu.
authors.forename: Alexa L
authors.initials: AL
authors.lastname: Swailes
authors.affiliation: Brigham and Women's Hospital, Boston, MA, United States.
authors.forename: Allison
authors.initials: A
authors.lastname: Gockley
authors.affiliation: Penn State Milton S. Hershey Medical Center, Hershey, PA, United States.
authors.forename: Rébécca
authors.initials: R
authors.lastname: Phaëton
authors.affiliation: Penn State Milton S. Hershey Medical Center, Hershey, PA, United States.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Kesterson
mesh_terms: D005260:Female; D059247:Fertility Preservation; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007044:Hysterectomy / Q000266:history / Q000379:methods*; D008197:Lymph Node Excision / Q000266:history / Q000379:methods*; D059351:Organ Sparing Treatments; D010525:Peripheral Nerves; D065287:Robotic Surgical Procedures / Q000266:history / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000266:history / Q000601:surgery*
keywords: Cervical cancer; Radical abdominal hysterectomy; Wertheim hysterectomy