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Nerve sparing technique in robotic-assisted radical hysterectomy: results

Authors

  • Blanca Gil-Ibáñez,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Berta Díaz-Feijoo,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Asunción Pérez-Benavente,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Oriol Puig-Puig,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Silvia Franco-Camps,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Cristina Centeno,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Jordi Xercavins,

    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Antonio Gil-Moreno

    Corresponding author
    1. Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
    • Correspondence to: Antonio Gil-Moreno, Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Passeig Vall d'Hebron 119–129, E-08035 Barcelona, Spain. E-mail: antonioimma@yahoo.es

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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. Copyright © 2013 John Wiley & Sons, Ltd.

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