LAPAROSCOPIC ASSISTANCE FOR EXTENDED RADICALITY OF RADICAL VAGINAL HYSTERECTOMY - DESCRIPTION OF A TECHNIQUE

Objective. We developed and standardized a surgical technique, which a llows radical hysterectomy by a combined laparoscopic and vaginal appr oach with radicalness equivalent to a type III procedure according to Rutledge. Method. Thirty-six consecutive patients with cervical cancer stage IB(1)IIIA with high risk for parametrial involvement were treat ed between May 1996 and March 1998. Results. Bilateral para-aortic and pelvic lymphadenectomy and resection of the cardinal ligaments was pe rformed laparoscopically using bipolar coagulation. Dissection of the ureters and resection of bladder pillars and uterosacral ligaments was performed transvaginally. On average 6.5 cm of cardinal ligament coul d be removed per side. Conclusions. With the laparoscopic-vaginal tech nique described a radical hysterectomy type III can be performed. (C) 1998 Academic Press.