Minimally Invasive Nerve-Sparing Radical Hysterectomy: A Win-Win Scenario

摘要

Radical hysterectomy is the mainstay of treatment for early stage cervical cancer undergoing surgical approach. 1The radical removal of the uterus within its surrounding tissue is considered a feasible and useful approach for patients affected by stage IB1 and IIA cervical cancer.Moreover, radical hysterectomy might have a role in selected patients undergoing neoadjuvant chemotherapy due to the presence of a locallyadvanced stage cervical cancer to the aim of reducing radiotherapy-related sequaele. 2ccumulating evidence support that radical hysterectomy guarantees favorable long-term oncologic outcomes, and minimize possible adverse events related to radiotherapy, especially in young women affected by cervical cancer.However, the execution of radical hysterectomy correlates with a non-negligible risk of developing pelvic floor dysfunctions, including voiding, sexual and anal issues due to the dissection of the nerves running in the tissues surrounding the uterus.Nerve sparing approach was introduced in order to preserve nerves and improving pelvic floor functions after the execution of radical hysterectomy.In order to reduce pelvic dysfunction rates, the inferior hypogastric plexus, sacral routs and the bladder branches have been anatomically mapped and partially preserved during nerve-sparing Querleu-Morrow type C1 radical hysterectomy. [2][3]3][4] Several data suggested that nerve sparing radical hysterectomy (type C1) guarantees the same oncologic results of conventional radical hysterectomy (type C2), minimizing the effects of surgery on bladder function. 3,4n the recent years laparoscopic and robotic-assisted approaches have emerged as the gold standard modality for the treatment of organ-confided gynecological cancers, including cervical carcinoma. 5,6In fact, albeit a