Nerve-sparing minilaparoscopic versus conventional laparoscopic radical hysterectomy plus systematic pelvic lymphadenectomy in cervical cancer patients

Surg Innov. 2013 Oct;20(5):493-501. doi: 10.1177/1553350612472986. Epub 2013 Jan 20.


Aim: To present our preliminary experience with nerve-sparing minilaparoscopic radical hysterectomy plus pelvic lymphadenectomy for the surgical treatment of cervical cancer and to compare outcomes with those of the conventional laparoscopic approach.

Methods: Data of 87 consecutive women who underwent minimally invasive surgery for early and locally advanced stage cervical cancer were prospectively collected. Ten women who underwent laparoscopic surgery using a nerve-sparing technique performed through 3-mm ancillary ports were compared with the 77 patients who had standard laparoscopic surgery previously with 3 sovrapubic 5-mm trocars.

Results: Minilaparoscopic radical hysterectomy was successfully accomplished in every case with no conversion to standard laparoscopy or open surgery. Two (2.6%) conversions to open surgery occurred in the conventional laparoscopy group. Surgical characteristics (operative time, estimated blood loss, and length of stay) and complication rate were similar between the 2 groups. No differences in the amount of parametrial and vaginal tissue removed were observed. The number of lymph nodes retrieved through minilaparoscopy was higher than conventional laparoscopy (30 [range = 26-38] vs 22 [range = 8-49]; P = .002). However, no difference was observed when the analysis was restricted to the last 10 conventional procedures (30 [range = 26-38] vs 29 [range = 24-49]; P = .81).

Conclusions: Our data show that minilaparoscopic radical hysterectomy with pelvic lymphadenectomy is a feasible procedure if performed by skilled surgeons.

Keywords: cervical cancer; laparoscopy; minilaparoscopy; needlescopic surgery; nerve sparing; radical hysterectomy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / methods*
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Lymph Node Excision / adverse effects
  • Lymph Node Excision / methods*
  • Middle Aged
  • Neoadjuvant Therapy
  • Organ Sparing Treatments / adverse effects
  • Organ Sparing Treatments / methods
  • Postoperative Complications / etiology
  • Prospective Studies
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / surgery*