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Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method

Radical hysterectomy (RH) is a standard treatment for early-stage cervical cancer. This surgery extirpates the uterus along with the paracervical tissues, vagina, and the paracolpium to achieve local control. Pelvic lymphadenectomy is a critical component of RH performed for regional control. A clea...

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Autores principales: Sakuragi, Noriaki, Kaneuchi, Masanori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers, Inc. 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799314/
https://www.ncbi.nlm.nih.gov/pubmed/35111930
http://dx.doi.org/10.1055/s-0041-1739119
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author Sakuragi, Noriaki
Kaneuchi, Masanori
author_facet Sakuragi, Noriaki
Kaneuchi, Masanori
author_sort Sakuragi, Noriaki
collection PubMed
description Radical hysterectomy (RH) is a standard treatment for early-stage cervical cancer. This surgery extirpates the uterus along with the paracervical tissues, vagina, and the paracolpium to achieve local control. Pelvic lymphadenectomy is a critical component of RH performed for regional control. A clear understanding of pelvic anatomy is critical to safely performing a RH and achieving optimal oncological and functional outcomes. The various surgical steps can damage the pelvic autonomic nerves, and a systematic nerve-sparing technique is used for the preservation of autonomic nerves. There is an intricate vascular network in the lateral paracervix (cardinal ligament) and the pelvic sidewall. We need to comprehend the three-dimensional structure of the vascular and nerve anatomy in the pelvis to perform RH effectively and safely. We can create six spaces around the uterine cervix, including the paravesical spaces, pararectal spaces, a vesicovaginal space, and a rectovaginal space to reveal the target of extirpation. It is critical to find the proper tissue plane separated by the layers of membranous connective tissue (fascia), in order to minimize intraoperative bleeding.
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spelling pubmed-87993142022-02-01 Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method Sakuragi, Noriaki Kaneuchi, Masanori Surg J (N Y) Radical hysterectomy (RH) is a standard treatment for early-stage cervical cancer. This surgery extirpates the uterus along with the paracervical tissues, vagina, and the paracolpium to achieve local control. Pelvic lymphadenectomy is a critical component of RH performed for regional control. A clear understanding of pelvic anatomy is critical to safely performing a RH and achieving optimal oncological and functional outcomes. The various surgical steps can damage the pelvic autonomic nerves, and a systematic nerve-sparing technique is used for the preservation of autonomic nerves. There is an intricate vascular network in the lateral paracervix (cardinal ligament) and the pelvic sidewall. We need to comprehend the three-dimensional structure of the vascular and nerve anatomy in the pelvis to perform RH effectively and safely. We can create six spaces around the uterine cervix, including the paravesical spaces, pararectal spaces, a vesicovaginal space, and a rectovaginal space to reveal the target of extirpation. It is critical to find the proper tissue plane separated by the layers of membranous connective tissue (fascia), in order to minimize intraoperative bleeding. Thieme Medical Publishers, Inc. 2021-12-01 /pmc/articles/PMC8799314/ /pubmed/35111930 http://dx.doi.org/10.1055/s-0041-1739119 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Sakuragi, Noriaki
Kaneuchi, Masanori
Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method
title Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method
title_full Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method
title_fullStr Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method
title_full_unstemmed Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method
title_short Nerve-Sparing Radical Hysterectomy Using the Okabayashi–Kobayashi Method
title_sort nerve-sparing radical hysterectomy using the okabayashi–kobayashi method
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799314/
https://www.ncbi.nlm.nih.gov/pubmed/35111930
http://dx.doi.org/10.1055/s-0041-1739119
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