Nerve-sparing radical hysterectomy: I. Anatomical principles and surgical technique

Objective: To improve the therapeutic index of the surgical treatment of ce rvical cancer. Methods: The technique of nerve-sparing radical hysterectomy was developed based on liposuction-assisted neuroanatomical studies of the female pelvis. Results: Compared with conventional radical hysterectomy, the nerve-sparing procedure permitted the resection of more parametrial tissue, particularly in the inferior and posterior parametrium as well as lateral to and behind the major vessels. Tissue trauma was reduced by dissection along embryolog ically preformed planes. Major portions of the autonomic pelvic nerve suppl y were dissected out and preserved. Conclusions: The application of new anatomical and tumor biological finding s in nerve-sparing radical hysterectomy may improve the surgical treatment of cervical cancer.